Ethel L Villanueva, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301045387 Issued in MI

Practice address

5528 Metropolitan Pkwy
Sterling Heights, MI 48310-4105

Phone

(586) 795-3232

Fax

(586) 795-5540

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: evillanueva63203@direct.hfhs.org

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932118353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 METROPOLITAN PKWY",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104105",
            "telephone_number": "586-795-3232",
            "fax_number": "586-795-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5528 METROPOLITAN PKWY",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104105",
            "telephone_number": "586-795-3232",
            "fax_number": "586-795-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "ETHEL",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301045387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1445368",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Veseli
• Allyson Vesprini
• Matthew Vibbard
• Liz Kimberly Vidana, RN
• David J Villanueva, M.D.
• Jasmin Villavicencio
• Charu Vinaik, PT
• Demetrius Vincent
• Edward Thomas Vincent, LMSW
• Vineyards Dental & Implants PLLC

• Pediatrics Physician in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.