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Physician Compare National (NPI:1093299422)

HEALTHCARE PROVIDER: LUIS MANUEL VILLEGAS MCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1093299422
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0446580799
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20190930000771
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name VILLEGAS
Individual professional last name
Provider First Name LUIS
Individual professional first name
Provider Middle Name M
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2011
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address URB SAN RAFAEL
Group Practice or individual's line 1 address
Line 2 Street Address CALLE ANTONIO JIMINEZ LANDRAU 90 1ER NIVEL
Group Practice or individual's line 2 address
City CAROLINA
Group Practice or individual's city
State PR
Group Practice or individual's state
Zip Code 00987
Group Practice or individual's zip code (9 digits when available)
Phone Number 7875972736
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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