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Physician Compare National (NPI:1376869784)

HEALTHCARE PROVIDER: NYRIA CAROLINA VILLARREAL M.D.

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

Individual Professional Information

NPI 1376869784
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1355372657
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20050826000155
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name VILLARREAL
Individual professional last name
Provider First Name NYRIA
Individual professional first name
Provider Middle Name CAROLINA
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1994
Individual professional's medical school graduation year
Primary Specialty INFECTIOUS DISEASE
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 INTERNAL MEDICINE
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties INTERNAL MEDICINE
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name COMMUNITY PHYSICIANS OF INDIANA INC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 1759416662
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 1069
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 1601 MEDICAL ARTS BLVD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 303
Group Practice or individual's line 2 address
City ANDERSON
Group Practice or individual's city
State IN
Group Practice or individual's state
Zip Code 460113460
Group Practice or individual's zip code (9 digits when available)
Phone Number 7652984377
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 150113
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 150088
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 ST. VINCENT ANDERSON REGIONAL HOSPITAL
Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment Y

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