Individual provider Active NPI

Joseph Jordan Villavicencio, MD

  • Diagnostic Radiology Physician
  • Miami, FL
National Provider Identifier
1912492992
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME14502 Issued in FL
Practice address
1475 NW 12TH Ave
Miami, FL 33136-1002
Phone
(305) 243-5512
NPI assigned
Jun 22, 2018
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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 ME14502 FL Primary

Addresses

Primary practice location

1475 NW 12TH Ave
Miami, FL 33136-1002

Mailing address

1475 NW 12TH Ave
Miami, FL 33136-1002
Phone (305) 243-5512

Other practice location 1

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone (954) 468-8932

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240809000543 FL Practitioner - Diagnostic Radiology 7315484292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

5555 Ponce de Leon Blvd
Coral Gables, FL 33146-2513
Phone (305) 689-8648

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME14502FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
University of Miami CurrentSince Jul 1, 2024 Accepting new patients

Locations

5555 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 585-1052

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1611 NW 12th Ave
#279
Miami, FL 33136
Phone (305) 585-7500

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1912492992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361002",
            "telephone_number": "305-243-5512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 S Andrews Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333162510",
            "country_code": "US",
            "telephone_number": "954-468-8932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLAVICENCIO",
        "first_name": "JOSEPH",
        "middle_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME14502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.