Individual provider Active NPI

Antonio Villa Padilla, FNP-BC

  • Family Nurse Practitioner
  • Castaic, CA
National Provider Identifier
1750056487
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95017665 Issued in CA
Practice address
28614 Meadowgrass Dr
Castaic, CA 91384-4329
Phone
(818) 282-5038
NPI assigned
Aug 13, 2021
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95017665 CA Primary

Addresses

Primary practice location

28614 Meadowgrass Dr
Castaic, CA 91384-4329

Mailing address

28614 Meadowgrass Dr
Castaic, CA 91384-4329
Phone (818) 282-5038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20241227000502 CA Order and Referring Only - Nurse Practitioner 4688063662

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Fernando Community HospitalGroup PAC ID 7719298728, 11 clinicians

Practice addresses (Care Compare)

732 Mott St
San Fernando, CA 91340-4237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95017665CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
San Fernando Community Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: avillapadilla38044@altamed.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1750056487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28614 MEADOWGRASS DR",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913844329",
            "telephone_number": "818-282-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28614 MEADOWGRASS DR",
            "city": "CASTAIC",
            "state": "CA",
            "postal_code": "913844329",
            "telephone_number": "818-282-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA PADILLA",
        "first_name": "ANTONIO",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castaic, CA

Sources for this page

Verify at the official NPI Registry.