Tristan Diego Villalobos, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA6226 Issued in TN

Practice address

1342 Papermill Pointe Way # K
Knoxville, TN 37909-1903

Phone

(865) 219-3506

Fax

(865) 588-5711

NPI assigned

Oct 16, 2024

Sex

Male

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

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Central Michigan College of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Associated Pain Specialists, PCGroup PAC ID 7214167733, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Associated Pain Specialists, PC

  • Pain Medicine Physician
  • Knoxville, TN
  • NPI 1487075099
  Medicare reassignment Care Compare group NPD
• Associated Pain Specialists, PC

  • Pain Medicine Physician
  • Morristown, TN
  • NPI 1679394514
  NPD

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1801616560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 PAPERMILL POINTE WAY # K",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091903",
            "telephone_number": "865-219-3506",
            "fax_number": "865-588-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1342 PAPERMILL POINTE WAY # K",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091903",
            "telephone_number": "865-219-3506",
            "fax_number": "865-588-5711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2103 Forest Dr Ste 5",
            "address_purpose": "LOCATION",
            "city": "Gray",
            "state": "TN",
            "postal_code": "376158423",
            "country_code": "US",
            "telephone_number": "423-794-3142",
            "fax_number": "423-794-3184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "TRISTAN",
        "middle_name": "DIEGO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA6226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "PA6226",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Everett Videla, MS
• Ariel Vidlund
• Roger Gordon Vieth, MD
• View Associates
• Juan Villalba, BS
• Jennifer A Villani
• Kristina Ann Villareal, LPC-MHSP
• Tiffany Danshelle Villegas, C.N.A.
• Charlotte Ryn Villeneuve
• Dana M Vince, LPC, MHSP

• Physician Assistant in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.