Individual provider Active NPI

David Scott Villanueva, PA-C

  • Medical Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1720073273
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2694 Issued in AZ
Practice address
6501 E Greenway Parkway
Suite 103-433
Scottsdale, AZ 85254-2065
Phone
(480) 347-0844
Fax
(480) 347-0885
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2694 AZ Primary

Addresses

Primary practice location

6501 E Greenway Parkway
Suite 103-433
Scottsdale, AZ 85254-2065

Mailing address

6501 E Greenway Parkway
Suite 103-433
Scottsdale, AZ 85254-2065
Phone (480) 347-0844

Other identifiers 2

IdentifierTypeStateIssuer
791493MedicaidAZ
P00060749OtherAZRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100211000523 AZ Practitioner - Physician Assistant 9436292596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berman Medical Consulting PCGroup PAC ID 8820027352, 8 clinicians

Practice addresses (Care Compare)

6320 W Union Hills Dr
Suite 140
Glendale, AZ 85308-7172

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2694AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel L. Kessler, M. D., Facp, P.L.L.C. Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1720073273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 E GREENWAY PARKWAY",
            "address_2": "SUITE 103-433",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542065",
            "telephone_number": "480-347-0844",
            "fax_number": "480-347-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 E GREENWAY PARKWAY",
            "address_2": "SUITE 103-433",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852542065",
            "telephone_number": "480-347-0844",
            "fax_number": "480-347-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "791493",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00060749",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.