Individual provider Active NPI

Elynette Vargas Villanueva, MD

  • General Practice Physician
  • Hato Rey, PR
National Provider Identifier
1740855683
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
23001 Issued in PR
Practice address
Sergio Cuevas
Hato Rey, PR 00927
Phone
(787) 758-8383
NPI assigned
May 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X 23001 PR Primary

Addresses

Primary practice location

Sergio Cuevas
Hato Rey, PR 00927

Mailing address

424 Northcoast VLG
Vega Alta, PR 00692-8717
Phone (787) 213-3319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20230123000142 PR Practitioner - General Practice 2163893645 Practice locations: Bayamon, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23001PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1740855683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 NORTHCOAST VLG",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006928717",
            "telephone_number": "787-213-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SERGIO CUEVAS",
            "city": "HATO REY",
            "state": "PR",
            "postal_code": "00927",
            "telephone_number": "787-758-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS VILLANUEVA",
        "first_name": "ELYNETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hato Rey, PR

Sources for this page

Verify at the official NPI Registry.