VALERIE LUISA VILLANUEVA PA-C
NPI 1104232701
Physician Assistant - Medical in Shaw Afb, SC

Q: What is Valerie Villanueva's NPI number?

The NPI number for Valerie Villanueva is 1104232701. It was assigned to this individual provider in the NPPES registry on July 3, 2014.

Q: What is Valerie Villanueva's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Active since July 03, 2014PECOS EnrolledAccepts Medicare Assignment

420 POLIFKA DR, SHAW AFB, SC 29152(038) 956-5428 Get Directions Write a Review

NPPES record last updated: January 8, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 8, 2026, May 9, 2018 (2 updates tracked since 2018).

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About Valerie Luisa Villanueva Pa-c NPPES

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

VALERIE LUISA VILLANUEVA PA-C (NPI 1104232701) is an individual medical provider in Shaw Afb, South Carolina and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS, is affiliated with Indiana University Health, and maintains a secondary practice location in Indianapolis.

NPPES Registry Identity

NPI1104232701

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameVALERIE LUISA VILLANUEVACredential: PA-C

Location Address420 POLIFKA DRShaw Afb, SC 29152-5100

Mailing Address420 Polifka DrShaw Afb, SC 29152-5100

Phone(038) 956-5428

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateJuly 3, 2014

Last NPPES UpdateJanuary 8, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 8, 2026

✔ NPI 1104232701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Also ListedPhysician AssistantTaxonomy 363A00000X · License 10005157A (IN)

420 POLIFKA DR, Shaw Afb, SC 29152

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Secondary Practice Location 1

Location 12625 E 62nd StIndianapolis, IN 46220-3189 · Phone (317) 251-6121

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Valerie Luisa Villanueva Pa-c 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 ID4385120963

PECOS Enrollment IDI20260114000253

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.

Hospital Affiliations CMS Care Compare

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

Indiana University Health

Acute Care Hospitals · Indianapolis, IN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150056

Location1701 N Senate BlvdIndianapolis, IN 46202 · Marion County

Emergency services Birthing friendly

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.

MRS. MALLORY SMITH NP

Nurse Practitioner (Primary Care)