MR. LUIS ANTONIO CACERES VILLALTA M.D.
NPI 1053803742
Family Medicine - Adult Medicine in Corona, NY

Q: What is Luis Caceres Villalta's NPI number?

The NPI number for Luis Caceres Villalta is 1053803742. It was assigned to this individual provider in the NPPES registry on May 30, 2018.

Q: What is Luis Caceres Villalta's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

Active since May 30, 2018PECOS Enrolled

3716 108TH ST, CORONA, NY 11368(718) 651-4000 Get Directions Write a Review

NPPES record last updated: July 7, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 7, 2021, Aug 2, 2018 (2 updates tracked since 2018).

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About Mr. Luis Antonio Caceres Villalta M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. LUIS ANTONIO CACERES VILLALTA M.D. (NPI 1053803742) is an individual adult medicine provider in Corona, New York, licensed in New York (310925-01) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053803742

Entity TypeIndividualMale

Primary Taxonomy207QA0505X

Provider Legal NameMR. LUIS ANTONIO CACERES VILLALTACredential: M.D.

Location Address3716 108TH STCorona, NY 11368-2025

Mailing Address3716 108th StCorona, NY 11368-2025 · (718) 651-4000

Phone(718) 651-4000

Sole ProprietorNo

Enumeration DateMay 30, 2018

Last NPPES UpdateJuly 7, 20212 updates tracked since enumeration

NPPES CertifiedJuly 7, 2021

✔ NPI 1053803742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QA0505X

License✔ Licensed in NY · 310925-01

Definition

The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

3716 108TH ST, Corona, NY 11368

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Luis Antonio Caceres Villalta M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11368 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.17 typical visit price

range $67.00 – $201.98

Typical copayment $26.04 (range $16.75 – $50.49)

Most-billed visit code 99203

Established Patient

$116.96 typical visit price

range $21.62 – $163.52

Typical copayment $29.24 (range $5.40 – $40.88)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MATTHEW KUSHER M.D.

Family Medicine