Active NPI
Victor Vidal Villarreal, M.D.
- Surgery Physician
- Andover, MA
National Provider Identifier
1851492714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 250056
- Practice address
- 140 Haverhill Street
Andover, MA 01810-1504 - Phone
- (978) 475-4202
- Fax
- (978) 475-4393
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| Surgery Physician | 208600000X | 250056 | MA | Primary |
Addresses
Primary practice location
140 Haverhill Street
Andover, MA 01810-1504
Mailing address
140 Haverhill Street
Andover, MA 01810-1504
Phone (978) 475-4202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 250056 | MA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328832000000",
"number": "1851492714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 HAVERHILL STREET",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018101504",
"telephone_number": "978-475-4202",
"fax_number": "978-475-4393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 HAVERHILL STREET",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018101504",
"telephone_number": "978-475-4202",
"fax_number": "978-475-4393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLARREAL",
"first_name": "VICTOR",
"middle_name": "VIDAL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2012-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "250056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.