DR. CARMEN VANESSA VILLABONA M.D.
NPI 1558432997
Internal Medicine - Endocrinology, Diabetes & Metabolism in Miami, FL

Q: What is Carmen Villabona's NPI number?

The NPI number for Carmen Villabona is 1558432997. It was assigned to this individual provider in the NPPES registry on November 9, 2006.

Q: What is Carmen Villabona's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Carmen Villabona was last updated on June 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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 November 09, 2006PECOS EnrolledAccepts Medicare Assignment

81.31/100

CMS Quality Rating

1450 NW 10TH AVE, MIAMI, FL 33136(305) 243-3636(305) 243-6575 Get Directions Write a Review

NPPES record last updated: June 6, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 6, 2022, Oct 8, 2019, Oct 3, 2019 (3 updates tracked since 2019).

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About Dr. Carmen Vanessa Villabona M.d. NPPES

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

DR. CARMEN VANESSA VILLABONA M.D. (NPI 1558432997) is an individual endocrinology, diabetes & metabolism provider in Miami, Florida, licensed in Florida (ME101645) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, is affiliated with Jackson Health System, and is a graduate of Other (1998).

NPPES Registry Identity

NPI1558432997

Entity TypeIndividualFemale

Primary Taxonomy207RE0101X

Provider Legal NameDR. CARMEN VANESSA VILLABONACredential: M.D.

Location Address1450 NW 10TH AVEMiami, FL 33136-1011

Mailing Address1400 Nw 10th Ave Ste 805Miami, FL 33136-1031 · (305) 243-3636 · Fax (305) 243-6575

Phone(305) 243-3636

Fax(305) 243-6575

Sole ProprietorNo

Medical School CMSOtherGraduated 1998

Enumeration DateNovember 9, 2006

Last NPPES UpdateJune 6, 20223 updates tracked since enumeration

NPPES CertifiedJune 6, 2022

✔ NPI 1558432997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

License✔ Licensed in FL · ME101645

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

Also ListedSpecialistTaxonomy 174400000X · License ME101645 (FL)

1450 NW 10TH AVE, Miami, FL 33136

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

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

Dr. Carmen Vanessa Villabona 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 ID8527120963

PECOS Enrollment IDI20081219000171

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.

Areas of Expertise CMS Part B claims 8

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.

154 services121 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

81 services50 patients

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

45 services35 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

27 services21 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.

22 services19 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

21 services21 patients

Hospital Affiliations CMS Care Compare

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

Jackson Health System

Acute Care Hospitals · Miami, FL

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100022

Location1611 NW 12th AveMiami, FL 33136 · Miami-Dade County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33136 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

$141.56 typical visit price

range $60.92 – $187.05

Typical copayment $35.39 (range $15.23 – $46.76)

Most-billed visit code 99204

Established Patient

$107.17 typical visit price

range $18.99 – $150.24

Typical copayment $26.79 (range $4.74 – $37.56)

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.

81.31/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

78.45

Promoting Interoperability

100

Improvement Activities

Cost

50.59

Reported Quality Measures

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Lower rates are better for this measure.

3%123 patients

Breast Cancer Screening

31%428 patients2/55-star benchmark: 93%

Cervical Cancer Screening

18%684 patients1/55-star benchmark: 98%

Chlamydia Screening for Women

15%34 patients

Colorectal Cancer Screening

27%783 patients2/55-star benchmark: 88%

Controlling High Blood Pressure

69%268 patients4/55-star benchmark: 91%

Diabetes: Eye Exam

33%271 patients2/55-star benchmark: 100%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

23%271 patients4/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

91%2,532 patients4/55-star benchmark: 100%

e-Prescribing

96%719 patients3/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

99%343 patients4/55-star benchmark: 100%

HIV Screening

22%1,120 patients2/55-star benchmark: 60%

Oncology: Medical and Radiation - Pain Intensity Quantified

91%33 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

45%1,318 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

82%1,217 patients4/55-star benchmark: 97%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

41%1,674 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 96% · 673 patients

Patients screened: 99% · 673 patients

17%23 patients1/55-star benchmark: 100%

Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation

86%22 patients

Provide Patients Electronic Access to Their Health Information

100%598 patients5/55-star benchmark: 100%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 7% · 365 patients

Patients totalRate: 15% · 365 patients

10%365 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

15 suppliers38 claims142 services$6.70 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

8 suppliers13 claims23 services$1.15 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

9 suppliers100 claims107 services$186.13 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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. GIANLUCA IACOBELLIS M.D. PH.D.

Internal Medicine (Endocrinology, Diabetes & Metabolism)