NPIMap

Individual provider Active NPI

Antonio Villalvazo

  • Family Medicine Physician
  • Fresno, CA
National Provider Identifier
1689772261
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C52080 Issued in CA
Practice address
6191 N Fresno St
Suite 101
Fresno, CA 93710-8612
Phone
(559) 227-1663
Fax
(559) 227-9083
NPI assigned
Sep 20, 2006
Last updated
Aug 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C52080 CA Primary

Addresses

Primary practice location

6191 N Fresno St
Suite 101
Fresno, CA 93710-8612

Mailing address

6191 N Fresno St
Suite 101
Fresno, CA 93710-8612
Phone (559) 227-1663

Other identifiers 1

IdentifierTypeStateIssuer
5430437MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070320000198 CA Practitioner - Family Practice 1153424700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6191 N Fresno St
Suite 101
Fresno, CA 93710-8612
Phone (559) 227-1663

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as individual
Quality
88.19
Improvement activities
40
Cost
77.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52080CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Antonio Villalvazo M.D. Inc Family Medicine CurrentSince Mar 20, 2007 Accepting new patients
Saint Agnes Medical Center PastSince Mar 20, 2007 Accepting new patients

Locations

6191 N Fresno St
Ste 101
Fresno, CA 93710
Phone (209) 224-2100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIFBCA/Endpoint/BIFBCA

Organizations & group practices 2

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 10

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1689772261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6191 N FRESNO ST",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108612",
            "telephone_number": "559-227-1663",
            "fax_number": "559-227-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6191 N FRESNO ST",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937108612",
            "telephone_number": "559-227-1663",
            "fax_number": "559-227-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALVAZO",
        "first_name": "ANTONIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C52080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5430437",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.