Individual provider Active NPI

Ferdinand Villanueva, OTR

  • Occupational Therapist
  • Azusa, CA
National Provider Identifier
1932208477
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT1465 Issued in CA
Practice address
1345 N Macneil Dr
Azusa, CA 91702-6903
Phone
(562) 618-7708
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT1465 CA Primary

Addresses

Primary practice location

1345 N Macneil Dr
Azusa, CA 91702-6903

Mailing address

1345 N Macneil Dr
Azusa, CA 91702-6903
Phone (562) 618-7708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051005000347 CA Practitioner - Occupational Therapist in Private Practice 4385679745 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2630 San Gabriel Blvd
Suite 103
Rosemead, CA 91770-5204
Phone (562) 618-7708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT1465CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Hills Healthcare Services, Inc. Current Accepting new patients
Progressive Occupational Therapy Services Inc Occupational Therapist CurrentSince May 1, 2018 Accepting new patients
Allcare Family Medical Group, Inc PastSince Feb 22, 2017 Accepting new patients
BVC Therapy Group Occupational Therapist PastSince Jul 1, 2005 Accepting new patients
Martha Cerda, Inc. Past Accepting new patients

Locations

2630 San Gabriel Blvd
Ste 103
Rosemead, CA 91770
Phone (562) 618-7708

Organizations & group practices 5

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1932208477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 N MACNEIL DR",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917026903",
            "telephone_number": "562-618-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 N MACNEIL DR",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917026903",
            "telephone_number": "562-618-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "FERDINAND",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT1465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Azusa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.