Kevin Ladines Villarama, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

34510 Issued in CA

Practice address

5478 N Palm Ave
Fresno, CA 93704-1940

Phone

(559) 447-4990

Fax

(559) 447-4994

NPI assigned

Jun 5, 2020

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

• Dr Saul Mendelsohn Optometrist a Professional Corp

  • Optometrist
  • Fresno, CA
  • NPI 1841464658
  NPD

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605312000000",
    "number": "1831713791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 E MUNCIE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937200405",
            "telephone_number": "559-824-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5478 N PALM AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937041940",
            "telephone_number": "559-447-4990",
            "fax_number": "559-447-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARAMA",
        "first_name": "KEVIN",
        "middle_name": "LADINES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-11-14",
        "certification_date": "2020-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymund Black Villanueva, RN
• Trina Lisa Villanueva, LMFT
• Alex Villar
• Monica Villar, LMFT
• Brittany Villarama, RN
• Kyle Villarama, PHD
• Rebecca Helena Villarama
• Daniel Villareal
• Jeannie Villareal
• Monique Maria Villareal

• Optometrist in Fresno, CA
• Providers in Fresno, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2020; 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.