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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JUAN-FERNANDO VILLEGAS-GARCIA M.D.
NPI 1164667424
Internal Medicine - Critical Care Medicine in Chicago, IL

Active since December 15, 2008PECOS EnrolledAccepts Medicare Assignment
80.83/100
CMS Quality Rating
CALIFORNIA AVE AT 15TH STREET, ROOM C 1400, CHICAGO, IL 60608(773) 257-5097 Get Directions Write a Review

NPPES record last updated: October 7, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Juan-fernando Villegas-garcia M.d. NPPES

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

JUAN-FERNANDO VILLEGAS-GARCIA M.D. (NPI 1164667424) is an individual critical care medicine provider in Chicago, Illinois, licensed in Illinois (036132345) and active in the NPI registry since December 2008. He is enrolled in Medicare PECOS, is affiliated with Mt Sinai Hospital Medical Center, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1164667424
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameJUAN-FERNANDO VILLEGAS-GARCIACredential: M.D.
Location AddressCALIFORNIA AVE AT 15TH STREET, ROOM C 1400Chicago, IL 60608
Mailing Address513 N Peoria StChicago, IL 60642-6739 · (248) 506-5169
Phone(773) 257-5097
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateDecember 15, 2008
Last NPPES UpdateOctober 7, 2026
NPPES CertifiedOctober 7, 2026
✔ NPI 1164667424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
License✔ Licensed in IL · 036132345
Definition
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Also ListedInternal MedicineTaxonomy 207R00000X · License 4301092105 (MI)
CALIFORNIA AVE AT 15TH STREET, Chicago, IL 60608
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, Oscar Health.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

Juan-fernando Villegas-garcia 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 ID9234379207
PECOS Enrollment IDI20130716000379
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 Reassignments

3

Medicare enrollment records show Juan-fernando Villegas-garcia reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mount Sinai Community Foundation
Same address
Rural
1501 S CALIFORNIA AVE
Chicago, IL 60608
  • Reassigned Medicare billing, Illinois enrollment
  • 646 clinicians in this Medicare group
NPI 1104858125 (773) 257-2000
Najjar Medical Ltd
4.0 mi
Pulmonary Disease
2525 S MICHIGAN AVE
Chicago, IL 60616
  • Reassigned Medicare billing, Illinois enrollment
  • 9 clinicians in this Medicare group
NPI 1386731867 (630) 653-2328
Knd Development 59 LLC
5.8 mi
Hospitalist
4058 W MELROSE ST
Chicago, IL 60641
  • Reassigned Medicare billing, Illinois enrollment
  • 122 clinicians in this Medicare group
NPI 1447589981 (773) 736-7000

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 7

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.

Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
182 services54 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
49 services27 patients
Follow-up inpatient or observation ventilation assistance and management 94003
Follow-up inpatient or observation ventilation assistance and management involves continuous monitoring and adjustment of your ventilator while in the hospital. This ensures your lungs receive the right amount of air, promoting your recovery and well-being.
28 services12 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
22 services20 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
14 services14 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.
12 services11 patients

Hospital Affiliations CMS Care Compare

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

Mt Sinai Hospital Medical Center

Acute Care Hospitals · Chicago, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140018
Location1500 S Fairfield AveChicago, IL 60608 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60608 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
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

80.83/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality64.96
Promoting Interoperability72
Improvement Activities40
Cost63.15

Other Providers at the Same Location NPPES

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

SINAI PATHOLOGY ASSOCIATES, INC.
Specialist
CALIFORNIA AVE AT 15TH STREET, ROOM F100
CHICAGO, IL 60608
Cook County (773) 542-2000

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 Juan-fernando Villegas-garcia's NPI number?

The NPI number for Juan-fernando Villegas-garcia is 1164667424. It was assigned to this individual provider in the NPPES registry on December 15, 2008.

Where is Juan-fernando Villegas-garcia located?

Juan-fernando Villegas-garcia practices at California Ave At 15th Street Room C 1400, Chicago, IL 60608. The listed phone number is (773) 257-5097.

What is Juan-fernando Villegas-garcia's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Juan-fernando Villegas-garcia enrolled in Medicare?

Yes. Juan-fernando Villegas-garcia 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 organizations bill Medicare for Juan-fernando Villegas-garcia's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Juan-fernando Villegas-garcia reassigns Medicare benefits to 3 organizations: Mount Sinai Community Foundation (Chicago, IL), Najjar Medical Ltd (Chicago, IL) and Knd Development 59 LLC (Chicago, IL). Each 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 Juan-fernando Villegas-garcia's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Juan-fernando Villegas-garcia accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Juan-fernando Villegas-garcia as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Juan-fernando Villegas-garcia affiliated with any hospitals?

According to CMS data, Juan-fernando Villegas-garcia is affiliated with Mt Sinai Hospital Medical Center.

When was this NPI record last updated?

The NPPES record for Juan-fernando Villegas-garcia was last updated on October 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 32 days 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.