Individual provider Active NPI

Teresita Villasis, M.D.

  • Family Medicine Physician
  • Dowagiac, MI
National Provider Identifier
1710970488
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301062539 Issued in MI
Practice address
310 S Front St
Dowagiac, MI 49047-1740
Phone
(269) 782-8696
Fax
(269) 782-0816
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 4301062539 MI Primary

Addresses

Primary practice location

310 S Front St
Dowagiac, MI 49047-1740

Mailing address

1010 Westwood Dr
Saint Joseph, MI 49085-3534
Phone (269) 428-9301

Other identifiers 1

IdentifierTypeStateIssuer
08-0-14-0008-1OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20100525000668 MI Practitioner - Family Practice 8224167515 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301062539MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Borgess Lee Hospital CurrentSince Mar 6, 1997 Accepting new patients
Ascension Borgess Lee Hospital CurrentSince Mar 6, 1997 Accepting new patients
Borgess Lee Memorial Hospital Past Accepting new patients
Ascension Borgess Lee Hospital Past Accepting new patients

Locations

520 Main St
Dowagiac, MI 49047
Phone (269) 390-0536

420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681

520 Main St
Ste A
Dowagiac, MI 49047
Phone (269) 783-3052

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1710970488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 WESTWOOD DR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853534",
            "telephone_number": "269-428-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S FRONT ST",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490471740",
            "telephone_number": "269-782-8696",
            "fax_number": "269-782-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLASIS",
        "first_name": "TERESITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301062539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "08-0-14-0008-1",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dowagiac, MI

Sources for this page

Verify at the official NPI Registry.