Carlos Eugenio Chavez de Paz Villanueva, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD22709 Issued in ME

Practice address

163 Van Buren Rd
Caribou, ME 04736

Phone

(207) 498-3111

NPI assigned

Feb 5, 2007

Last updated

Jan 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME, DE, MD3 enrollments

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 3

Specialty

General Surgery

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidalhealth Physician Network, Inc.Group PAC ID 7315901253, 115 clinicians

Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Home Care Home health agency, Laurel, DE, CCN 087036
• Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Tidalhealth Physician Network, Inc.

  • Family Medicine Physician
  • Seaford, DE
  • NPI 1467534636
  Medicare reassignment Care Compare group NPD
• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735
  Medicare reassignment Care Compare group NPD
• Pines Health Services

  • Internal Medicine Physician
  • Caribou, ME
  • NPI 1942277819

  Surgery

  Medicare reassignment NPD
• Pines Health Services

  dba Washburn Health Center

  • Federally Qualified Health Center (FQHC)
  • Washburn, ME
  • NPI 1922449834
  NPD
• Tidalhealth Physician Network, Inc.

  • Surgery Physician
  • Seaford, DE
  • NPI 1396558623
  NPD (past)
• Tidalhealth Specialty Care, LLC

  • Adult Mental Health Clinic/Center
  • Salisbury, MD
  • NPI 1962027094
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peninsula Home Care at Nanticoke LLC

  • Home Health Agency
  • Laurel, DE
  • NPI 1780664953
  Care Compare affiliation
• Tidalhealth Nanticoke, Inc

  • General Acute Care Hospital
  • Seaford, DE
  • NPI 1245214477
  Care Compare affiliation

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1770622011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047360480",
            "telephone_number": "909-252-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 VAN BUREN RD",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "04736",
            "telephone_number": "207-498-3111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_2": "General Surgery Department",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVEZ DE PAZ VILLANUEVA",
        "first_name": "CARLOS",
        "middle_name": "EUGENIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ME",
            "license": "MD22709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Change in Mind Counseling, LLC
• Emma Chapin
• Katelyn Marie Chapman, PT, DPT
• Andrea Chasse, LCSW
• Bobbie Chasse
• Tegan Kar Lam Chu, OD
• Circle of Learning, Inc
• City of Caribou (Cary Medical Center)
• City of Caribou (Caribou Fire & Ambulance Department)
• Victoria Marilyn Clark, PT, DPT, OCS

• Surgery Physician in Caribou, ME
• Providers in Caribou, ME by specialty
• Surgery Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.