Individual provider Active NPI

Juanito S. Villanueva, MD

  • Diagnostic Radiology Physician
  • Oakland, CA
National Provider Identifier
1891781993
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G61893 Issued in CA
Practice address
411 30TH St
#508
Oakland, CA 94609-3310
Phone
(925) 274-4950
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G61893 CA Primary

Addresses

Primary practice location

411 30TH St
#508
Oakland, CA 94609-3310

Mailing address

411 30TH St
#508
Oakland, CA 94609-3310
Phone (925) 274-4950

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

LicenseStateTypeSpecialty
61893CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Radiation Oncology Centers LLC Diagnostic Radiology Past Accepting new patients
Vallejo Open MRI Center Diagnostic Radiology Past Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients
Riverside Radiology Medical Group, Inc. Diagnostic Radiology Past Accepting new patients
Universal Radiology Consultants PC Diagnostic Radiology PastSince Aug 12, 2017 Accepting new patients
Pco PC Diagnostic Radiology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jvillanueva101957@direct.llu.edu

Organizations & group practices 6

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1891781993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 30TH ST",
            "address_2": "#508",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093310",
            "telephone_number": "925-274-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 30TH ST",
            "address_2": "#508",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093310",
            "telephone_number": "925-274-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "JUANITO",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G61893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.