Individual provider Active NPI

Rafael Villicana, MD

  • Nephrology Physician
  • Loma Linda, CA
National Provider Identifier
1669496832
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A83031 Issued in CA
Practice address
25865 Barton Rd
Suite 101
Loma Linda, CA 92354-3895
Phone
(909) 558-3636
Fax
(909) 558-3722
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A83031 CA Primary

Addresses

Primary practice location

25865 Barton Rd
Suite 101
Loma Linda, CA 92354-3895

Mailing address

25865 Barton Road
Suite 101
Loma Linda, CA 92354
Phone (909) 558-3636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061212000648 CA Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Neurology 5597667691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Michigan State University College of Human Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Faculty Physicians and Surgeons of LlusmGroup PAC ID 1153227814, 1,313 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

25845 Barton Rd
Suite F
Loma Linda, CA 92354-3899
Phone (909) 558-2828

File Number
Suite 54701
Los Angeles, CA 90074-4701

Hospital & facility affiliations

  • Loma Linda University Medical Center Hospital, Loma Linda, CA, CCN 050327

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
83031CAMDPharmacist
A83031CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm CurrentSince Apr 1, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
University of California San Francisco Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients

Locations

25865 Barton Rd
Ste 101
Loma Linda, CA 92354
Phone (909) 558-2890

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Interoperability endpoints

  • Direct secure messaging: rvillicana92166@direct.llu.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1669496832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25865 BARTON ROAD",
            "address_2": "SUITE 101",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-3636",
            "fax_number": "909-558-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25865 BARTON RD",
            "address_2": "SUITE 101",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543895",
            "telephone_number": "909-558-3636",
            "fax_number": "909-558-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLICANA",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A83031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.