Individual provider Active NPI

Raul D Villalobos

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1700589249
Registry record updated Sep 24, 2024
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OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(3) exclusion effective May 20, 2026.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
166037 Issued in PR
Practice address
107 Calle Padre Las Casas
San Juan, PR 00918-3104
Phone
(787) 767-8758
NPI assigned
Mar 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 166037 PR Primary

Addresses

Primary practice location

107 Calle Padre Las Casas
San Juan, PR 00918-3104

Mailing address

PO Box 193044
San Juan, PR 00919-3044
Phone (787) 767-8758

Other practice location 1

Carolina Shopping Court
Suite 201 a
Carolina, PR 00985-5615
Phone (787) 767-8758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
166037PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1700589249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193044",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009193044",
            "telephone_number": "787-767-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 CALLE PADRE LAS CASAS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183104",
            "telephone_number": "787-767-8758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "CAROLINA SHOPPING COURT",
            "address_2": "SUITE 201 A",
            "address_purpose": "LOCATION",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855615",
            "country_code": "US",
            "telephone_number": "787-767-8758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "RAUL",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-23",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "166037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.