DR. GONZALO RAFAEL DE VILLA M.D.
NPI 1053845545
Family Medicine in Clinton, TN

Q: What is Gonzalo De Villa's NPI number?

The NPI number for Gonzalo De Villa is 1053845545. It was assigned to this individual provider in the NPPES registry on April 12, 2017.

Q: What is Gonzalo De Villa's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Gonzalo De Villa was last updated on April 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 12, 2017PECOS EnrolledAccepts Medicare Assignment

102 S CHARLES G SEIVERS BLVD, CLINTON, TN 37716(865) 457-4702 Get Directions Write a Review

NPPES record last updated: April 27, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 27, 2021, Aug 19, 2020, Jul 21, 2020 and 2 more (5 updates tracked since 2017).

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About Dr. Gonzalo Rafael De Villa M.d. NPPES

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

DR. GONZALO RAFAEL DE VILLA M.D. (NPI 1053845545) is an individual family medicine provider in Clinton, Tennessee, licensed in Tennessee (61482) and active in the NPI registry since April 2017. He is enrolled in Medicare PECOS, is affiliated with Methodist Medical Center Of Oak Ridge, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1053845545

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. GONZALO RAFAEL DE VILLACredential: M.D.

Location Address102 S CHARLES G SEIVERS BLVDClinton, TN 37716-3916

Mailing Address102 S Charles G Seivers BlvdClinton, TN 37716-3916 · (865) 457-4702

Phone(865) 457-4702

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateApril 12, 2017

Last NPPES UpdateApril 27, 20215 updates tracked since enumeration

NPPES CertifiedApril 27, 2021

✔ NPI 1053845545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TN · 61482

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

102 S CHARLES G SEIVERS BLVD, Clinton, TN 37716

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Other Identifiers 1

MedicaidQ042265TN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Gonzalo Rafael De Villa M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9436426749

PECOS Enrollment IDI20200807002982

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.

Medicare Billing Reassignment

Medicare enrollment records show Gonzalo De Villa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Covenant Medical Group, Inc.

11 mi

Family Medicine

1420 CENTERPOINT BLVD
Knoxville, TN 37932

Reassigned Medicare billing, Tennessee enrollment
504 clinicians in this Medicare group

NPI 1457302010 (865) 374-5200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

168 services100 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

140 services77 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

71 services55 patients

Blood test, lipids (cholesterol and triglycerides) 80061

A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.

58 services54 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test 85027

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

43 services41 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

42 services28 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

41 services33 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

41 services41 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

40 services40 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

39 services28 patients

Blood test, thyroid stimulating hormone (tsh) 84443

A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.

25 services21 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

18 services17 patients

Smoking and tobacco use intensive counseling, 4-10 minutes 99406

This service provides brief, intensive counseling (4-10 minutes) to support you in quitting smoking or tobacco use. It involves discussing the risks of tobacco use, benefits of quitting, and strategies to help you stop. It's a critical step towards a healthier lifestyle.

13 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Methodist Medical Center Of Oak Ridge

Acute Care Hospitals · Oak Ridge, TN

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440034

Location990 Oak Ridge Turnpike Box 529Oak Ridge, TN 37830 · Anderson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37716 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

Other Providers at the Same Location NPPES 9

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

DR. JOSE J MALAGON MD

Family Medicine