NPIMap

Individual provider Active NPI

Patrick Daniel Vargas Villazon, M.D.

  • Adolescent Medicine (Internal Medicine) Physician
  • Nampa, ID
National Provider Identifier
1821229279
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
M-11976 Issued in ID
Practice address
4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone
(208) 463-5000
NPI assigned
Aug 3, 2009
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 240133 MA
Adolescent Medicine (Internal Medicine) Physician 207RA0000X M-11976 ID Primary

Addresses

Primary practice location

4300 E Flamingo Ave
Nampa, ID 83687-3138

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 302-9342

Other practice location 1

1512 12th Ave Rd
Nampa, ID 83686-6008
Phone (208) 463-5000 ext. 3

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131001000242 ID Practitioner - Internal Medicine 6709010903 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Physicians of IdahoGroup PAC ID 4688705346, 47 clinicians

Practice addresses (Care Compare)

1512 12TH Ave Rd
Nampa, ID 83686-6008
Phone (208) 463-5000

3025 W Cherry LN
Meridian, ID 83642-8531

4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 205-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
240133MAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Nov 16, 2017 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Nov 16, 2017 Accepting new patients
Hospitalist Medicine Physicians of Idaho- Nampa PLLC CurrentSince Jan 13, 2021 Accepting new patients
Vibra Physicians LLC CurrentSince Nov 6, 2017 Accepting new patients
Sound Physicians of Idaho CurrentSince Jul 15, 2013 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Feb 1, 2026 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Feb 1, 2026 Accepting new patients

Locations

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

2131 S Bonito Way
Meridian, ID 83642
Phone (208) 202-4700

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

1512 12th Ave Rd
Nampa, ID 83686
Phone (208) 463-5000

4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 367-6416

8081 Royal Ridge Pkwy
Ste 120
Irving, TX 75063

Interoperability endpoints

  • Direct secure messaging: pvargasvillazon1563405@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1821229279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-302-9342",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 E FLAMINGO AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836873138",
            "telephone_number": "208-463-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1512 12th Ave Rd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836866008",
            "country_code": "US",
            "telephone_number": "208-463-5000 x3",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARGAS VILLAZON",
        "first_name": "PATRICK",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-03",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "240133",
            "primary": false
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "ID",
            "license": "M-11976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.