Individual provider Active NPI

Laura Villafane, PA

  • Physician Assistant
  • Weston, FL
National Provider Identifier
1831615178
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2625 Executive Park Dr Ste 7
Weston, FL 33331-3634
Phone
(954) 385-1544
NPI assigned
Aug 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X FL Primary

Addresses

Primary practice location

2625 Executive Park Dr Ste 7
Weston, FL 33331-3634

Mailing address

15051 S Tamiami TRL Ste 203
Fort Myers, FL 33908-5182
Phone (239) 437-8810

Other practice location 1

603 N Flamingo Rd Ste 350
Pembroke Pines, FL 33028-1013
Phone (954) 435-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20180208001889 FL Practitioner - Physician Assistant 1153681374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

1015 Crosspointe Dr
Naples, FL 34110-0949
Phone (239) 596-9075

2625 Executive Park Dr
Suite 7
Weston, FL 33331-3634
Phone (954) 385-1544

603 N Flamingo Rd
Suite 350
Pembroke Pines, FL 33028-1013
Phone (954) 435-5100

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Oct 1, 2017 Accepting new patients

Locations

15051 S Tamiami Trl
Ste 203
Fort Myers, FL 33908
Phone (239) 732-5959

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

603 N Flamingo Rd
Ste 350
Pembroke Pnes, FL 33028
Phone (954) 435-5100

2625 Executive Park Dr
Ste 7
Weston, FL 33331
Phone (954) 385-1544

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1831615178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15051 S TAMIAMI TRL STE 203",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085182",
            "telephone_number": "239-437-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 EXECUTIVE PARK DR STE 7",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313634",
            "telephone_number": "954-385-1544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 N Flamingo Rd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Pembroke Pines",
            "state": "FL",
            "postal_code": "330281013",
            "country_code": "US",
            "telephone_number": "954-435-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLAFANE",
        "first_name": "LAURA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, FL

Sources for this page

Verify at the official NPI Registry.