NPIMap

Individual provider Active NPI

Marivic Delos Reyes Villa, M.D.

  • Internal Medicine Physician
  • Lady Lake, FL
National Provider Identifier
1629092564
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME68756 Issued in FL
Practice address
39512 Woodgate LN
Lady Lake, FL 32159-3350
Phone
(352) 630-0108
Fax
(352) 307-8442
NPI assigned
Jul 26, 2006
Last updated
Aug 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME68756 FL
Internal Medicine Physician 207R00000X ME68756 FL Primary

Addresses

Primary practice location

39512 Woodgate LN
Lady Lake, FL 32159-3350

Mailing address

1507 Buenos Aires Blvd
The Villages, FL 32159-8974
Phone (352) 561-6299

Other identifiers 1

IdentifierTypeStateIssuer
378148800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041113000083 FL Practitioner - Internal MedicinePractitioner - Pulmonary Disease 1850284878 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pathways Clinical Partners, LLCGroup PAC ID 5597162693, 8 clinicians
Tricounty Physicians LLCGroup PAC ID 9133394547, 4 clinicians

Practice addresses (Care Compare)

1031 W Magnolia St
Leesburg, FL 34748-5730
Phone (800) 632-6228

1507 Buenos Aires Blvd
The Villages, FL 32159-8974
Phone (352) 561-6299

4068 E State Rd
Suite 44
Wildwood, FL 34785-7486
Phone (352) 564-3655

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Villa Health Pulmonary LLC Pulmonary Disease CurrentSince Mar 1, 2020 Accepting new patients
Pathways Clinical Partners, LLC CurrentSince Jul 1, 2024 Accepting new patients
Tricounty Physicians, LLC Internal Medicine CurrentSince Apr 15, 2013 Accepting new patients
Tri-County Pulmonary & Multi-Specialty Group P a Pulmonary Disease PastSince Nov 1, 1999 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Tricounty Physicians, LLC Pulmonary Disease Past Accepting new patients
VMG Pulmonary & Sleep Disorder Center PA PastSince Jul 1, 2010 Accepting new patients
VMG Urgent Care PA Past Accepting new patients

Locations

1031 W Magnolia St
Leesburg, FL 34748
Phone (352) 315-0459

1507 Buenos Aires Blvd
The Villages, FL 32159
Phone (352) 350-1600

1507 Buenos Aires Blvd
Ste B
The Villages, FL 32159
Phone (352) 350-1600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17462/brand/2/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/GICIBD/Endpoint/GICIBD
  • Direct secure messaging: marivic.villa@vhc1.eclinicaldirectplus.com
  • Direct secure messaging: mvilla565881@direct.shands.ufl.edu

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1629092564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 BUENOS AIRES BLVD",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321598974",
            "telephone_number": "352-561-6299",
            "fax_number": "352-750-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39512 WOODGATE LN",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321593350",
            "telephone_number": "352-630-0108",
            "fax_number": "352-307-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA",
        "first_name": "MARIVIC",
        "middle_name": "DELOS REYES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME68756",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME68756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378148800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lady Lake, FL

Sources for this page

Verify at the official NPI Registry.