Elizabeth Villavicencio, NURSE PRACT

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F3814531 Issued in NY

Practice address

347 Edison St
Staten Island, NY 10306-3034

Phone

(718) 351-1136

Fax

(718) 667-9711

NPI assigned

Oct 3, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elizabeth Flint Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

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.

• Island Medical Specialists, P.L.L.C.

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1407844160
  NPD (past)
• Richmond University Medical Center

  • Multi-Specialty Clinic/Center
  • Staten Island, NY
  • NPI 1811054042
  NPD (past)

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1790772010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 FOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103031796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 EDISON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103063034",
            "telephone_number": "718-351-1136",
            "fax_number": "718-667-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLAVICENCIO",
        "first_name": "ELIZABETH",
        "credential": "NURSE PRACT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F3814531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02389417",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "FLINT",
            "credential": "NURSE PRACT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sissy L Villamar
• Janine Banina Villanueva, LPN
• Jocelyn Villanueva, MD
• Christina Villarino
• Liezl R Villaverde, MD
• Karen Roxana Villegas Pavia
• Miriam Villegas, RN
• Sunithi Krishnan Vinay, M.D
• Mikerlon Vincent, RN
• Tammy J Vinciguerra, OTR/L

• Pediatric Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.