Jason Fortuno Villareal, PT

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT32980 Issued in CA

Practice address

1740 Thompson Rd
Coos Bay, OR 97420-2151

Phone

(541) 266-3658

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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

• Therapydia, Inc.

  • Physical Therapist
  • Portland, OR
  • NPI 1346672797
  Medicare reassignment
• HMZ Ventures Corporation

  • Nephrology Physician
  • North Bend, OR
  • NPI 1558824391
  NPD (past)
• South Coast Orthopaedic Associates, PC

  • Orthopaedic Surgery Physician
  • Coos Bay, OR
  • NPI 1245284751
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1639185168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141830",
            "telephone_number": "503-477-4802",
            "fax_number": "503-477-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202151",
            "telephone_number": "541-266-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAREAL",
        "first_name": "JASON",
        "middle_name": "FORTUNO",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT32980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garry T Vallier, M.D.
• Mark L. Van Over, FNP
• Bradley Dean Veldstra, MD
• Alfredo J Velez, M.D.
• Alberto Verduzco Ramirez, MSCP
• Paul C Vitt, DO
• Patrick Beauregard Vondippe, MD
• Joanna Renee Vonseggern, PTA
• Benjamin Levi Voth, D.C.
• Swetha Vutukuri

• Specialist in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.