Logan Andrew Villarreal, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61113757 Issued in WA

Practice address

624 E Front Ave
Spokane, WA 99202-2139

Phone

(509) 626-9900

Fax

(509) 626-9917

NPI assigned

May 10, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 4

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lvillarreal924128@wm.providencedirect.org
• Direct secure messaging: logan.villarreal.p1@direct.ritzville.nextgenshare.com

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.

• Providence Health & Services Washington

  dba Providence Medical Group

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Providence Health & Services Washington

  dba PMG PHC Providence Express Care

  • General Practice Physician
  • Spokane, WA
  • NPI 1306391446
  NPD

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

• Providence Health & Services - Wa

  dba Prov Scred Hrt Med Ctr & Chlds Hos

  • General Acute Care Hospital
  • Spokane, WA
  • NPI 1144471715
  Care Compare affiliation

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1689164188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E FRONT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022139",
            "telephone_number": "509-626-9900",
            "fax_number": "509-626-9917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "551 E Hawthorne Rd",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992181417",
            "country_code": "US",
            "telephone_number": "509-489-2369",
            "fax_number": "509-227-7070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "LOGAN",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61113757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvillarreal924128@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "551 E Hawthorne Rd",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992181417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvillarreal924128@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "624 E Front Ave",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992022139",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvillarreal924128@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "421 E Division",
            "city": "SPOKANE",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992021331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lvillarreal924128@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "16528 E Desmet Ct",
            "city": "Spokane Valley",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992163522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mindy Villa
• Raymond M Villalobos, M.D.
• Michelle Villanueva, CP61057148
• Mollie Jo-Gabrielle Villarreal-Ruiz
• Carly Villarreal, MD
• Hope Villars, SUDPT
• Christian Villegas, PE70050058
• Teodulo T Vince-Cruz, M.D.
• Cameron Vincent
• Hali Lynn Vincent, RN

• Family Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.