Individual provider Active NPI

Jacy Villa, M.D.

  • Hematology & Oncology Physician
  • Boynton Beach, FL
National Provider Identifier
1811995434
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME80441 Issued in FL
Practice address
2623 S Seacrest Blvd
Suite 216
Boynton Beach, FL 33435-7501
Phone
(561) 742-0065
Fax
(561) 742-0105
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 24551 NH
Medical Oncology Physician 207RX0202X ME80441 FL
Hematology & Oncology Physician 207RH0003X ME80441 FL Primary

Addresses

Primary practice location

2623 S Seacrest Blvd
Suite 216
Boynton Beach, FL 33435-7501

Mailing address

2234 Colonial Blvd
Attn: Payer Contracting & Relations Dept.
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other practice location 1

2300 Southwood Dr
Nashua, NH 03063-1818
Phone (603) 695-2500

Other identifiers 8

IdentifierTypeStateIssuer
P1035622OtherFLFREEDOM
279218OtherFLAVMED
14392OtherFLDIMENSION
P01594402OtherFLRR MEDICARE
5753526OtherFLAETNA
8490121OtherFLCIGNA
P971389OtherFLOPTIMUM
57987OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NH2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20100727000569 FL Practitioner - Hematology/Oncology 8729170519 Reassigns benefits to 1 organization
I20230822003448 NH Practitioner - Hematology/Oncology 8729170519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

2300 Southwood Dr
Nashua, NH 03063-1818
Phone (603) 577-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME80441FLMDMedical Oncology Physician
24551NHMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC CurrentSince Feb 1, 2016 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 9, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic Hematology & Oncology CurrentSince Aug 9, 2023 Accepting new patients
Genesiscare USA of Florida LLC Hematology & Oncology Current Accepting new patients
Genesiscare USA of Florida LLC Hematology & Oncology CurrentSince Feb 1, 2016 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 9, 2023 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 9, 2023 Accepting new patients
Genesiscare USA of Florida LLC Past Accepting new patients

Locations

1601 Clint Moore Rd
Ste 180
Boca Raton, FL 33487
Phone (561) 939-0600

2623 S Seacrest Blvd
Ste 216
Boynton Beach, FL 33435
Phone (561) 734-5080

1419 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3202

2234 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 931-7212

2160 Colonial Blvd
Fort Myers, FL 33907

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

3343 S State Road 7
Wellington, FL 33449
Phone (561) 795-8945

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

87 McGregor St
Manchester, NH 03102
Phone (603) 629-1828

2300 Southwood Dr
Nashua, NH 03063
Phone (603) 577-4170

Interoperability endpoints

  • Direct secure messaging: jvilla532143@direct.dartmouth-hitchcock.org
  • Direct secure messaging: jacy.villa@spbc.ikm.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1811995434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS DEPT.",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 S SEACREST BLVD",
            "address_2": "SUITE 216",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357501",
            "telephone_number": "561-742-0065",
            "fax_number": "561-742-0105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Southwood Dr",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "030631818",
            "country_code": "US",
            "telephone_number": "603-695-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLA",
        "first_name": "JACY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NH",
            "license": "24551",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "FL",
            "license": "ME80441",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME80441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM",
            "identifier": "P1035622",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "279218",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIMENSION",
            "identifier": "14392",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01594402",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5753526",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8490121",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P971389",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "57987",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.