Elmo Villanueva, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

035713 Issued in CT

Practice address

506 Cromwell Ave
Rocky Hill, CT 06067-1851

Phone

(860) 529-1287

Fax

(860) 721-6311

NPI assigned

Jul 23, 2006

Last updated

Jun 21, 2021By 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 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Hartford Physician Services PC

  dba Hartford Medical Group

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1164404117
  NPD (past)
• Johnson Professional Associates, PC

  • Hospitalist Physician
  • Stafford Springs, CT
  • NPI 1770564262

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1831110717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 CROMWELL AVE",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671851",
            "telephone_number": "860-529-1287",
            "fax_number": "860-721-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 CROMWELL AVE",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671851",
            "telephone_number": "860-529-1287",
            "fax_number": "860-721-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "ELMO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "035713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "010035713CT03",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0V6230",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001357137",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evillanueva16863@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Saint Francis Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "506 Cromwell Ave",
            "city": "Rocky Hill",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060671851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Naga Aditya Teja Vemparala, MS PT, DIPLOMATE MDT
• Lindsay Doreen Vendetta
• Alexander D Vendetto
• Pranav Shaiwal Verma
• Veterans Home and Health Care Facility
• Visual Perceptions LLC (Robert W. Aube Jr., O.D.)
• Visual Perceptions-Rocky Hill, LLC
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2900)
• Walnut Dental (Children and Family Dentistry of Rocky Hill)
• Walnut Dental, Inc

• Internal Medicine Physician in Rocky Hill, CT
• Providers in Rocky Hill, CT by specialty
• Internal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.