GAVIN VILLACORTA CRNP
NPI 1093411688
Nurse Practitioner in Philadelphia, PA
About Gavin Villacorta Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GAVIN VILLACORTA CRNP (NPI 1093411688) is an individual nurse practitioner in Philadelphia, Pennsylvania, licensed in Pennsylvania (SP027036) and active in the NPI registry since February 2023. He is enrolled in Medicare PECOS, is affiliated with West Jersey Hospital, and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
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
Gavin Villacorta Crnp 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.
Medicare Billing Reassignment
Medicare enrollment records show Gavin Villacorta reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Philadelphia, PA 19107
- Reassigned Medicare billing, Pennsylvania enrollment
- 3,488 clinicians in this Medicare group
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 3
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.
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
West Jersey Hospital
Acute Care Hospitals · Voorhees, NJHospital Of Univ Of Pennsylvania
Acute Care Hospitals · Philadelphia, PAChester County Hospital
Acute Care Hospitals · West Chester, PAPennsylvania Hospital
Acute Care Hospitals · Philadelphia, PAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PHILADELPHIA, PA 19107
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Gavin Villacorta's NPI number?
The NPI number for Gavin Villacorta is 1093411688. It was assigned to this individual provider in the NPPES registry on February 6, 2023.
Where is Gavin Villacorta located?
Gavin Villacorta practices at 330 S 9th St, Philadelphia, PA 19107. The listed phone number is (215) 829-6500.
What is Gavin Villacorta's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Gavin Villacorta enrolled in Medicare?
Yes. Gavin Villacorta is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Gavin Villacorta's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Gavin Villacorta reassigns Medicare benefits to University Of Penn-Medical Group (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gavin Villacorta's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Gavin Villacorta affiliated with any hospitals?
According to CMS data, Gavin Villacorta is affiliated with West Jersey Hospital, Hospital Of Univ Of Pennsylvania, Chester County Hospital and Pennsylvania Hospital.
When was this NPI record last updated?
The NPPES record for Gavin Villacorta was last updated on February 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Gavin Villacorta, CRNP · NPI 1093411688
Nurse Practitioner physician in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since February 6, 2023.
## Identity
- **NPI:** 1093411688 (Entity type: Individual)
- **Enumerated:** February 6, 2023
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** SP027036 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 330 S 9TH ST, Philadelphia, PA 19107-6103
- **Phone:** (215) 829-6500 · **Fax:** (215) 829-6606
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** University Of Penn-Medical Group (NPI 1669860854, Philadelphia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** February 6, 2023
---
Source: [NPI Profile](https://npiprofile.com/npi/1093411688) · Data from the CMS NPPES public registry.