Active NPI
Geovanna Paola Erazo Villegas, PA
- Physician Assistant
- Briarwood, NY
National Provider Identifier
1760875272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 14128 84TH Dr
Apt 6G
Briarwood, NY 11435-2413 - Phone
- (516) 287-0493
- NPI assigned
- Mar 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
14128 84TH Dr
Apt 6G
Briarwood, NY 11435-2413
Mailing address
14128 84TH Dr
Apt 6G
Briarwood, NY 11435-2413
Phone (516) 287-0493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150806010703 | NY | Order and Referring Only - Physician Assistant | 1951615772 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018601 | NY | MD | Clinical Psychologist |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472256000000",
"number": "1760875272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14128 84TH DR",
"address_2": "APT 6G",
"city": "BRIARWOOD",
"state": "NY",
"postal_code": "114352413",
"telephone_number": "516-287-0493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14128 84TH DR",
"address_2": "APT 6G",
"city": "BRIARWOOD",
"state": "NY",
"postal_code": "114352413",
"telephone_number": "516-287-0493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERAZO VILLEGAS",
"first_name": "GEOVANNA",
"middle_name": "PAOLA",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-08",
"last_updated": "2016-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Briarwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.