DR. RAFAEL VILLICANA MD
NPI 1669496832
Internal Medicine - Nephrology in Loma Linda, CA

Q: What is Rafael Villicana's NPI number?

The NPI number for Rafael Villicana is 1669496832. It was assigned to this individual provider in the NPPES registry on July 27, 2006.

Q: What is Rafael Villicana's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Rafael Villicana was last updated on April 13, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 27, 2006PECOS EnrolledAccepts Medicare Assignment

85.18/100

CMS Quality Rating

25865 BARTON RD, SUITE 101, LOMA LINDA, CA 92354(909) 558-3636(909) 558-3722 Get Directions Write a Review

NPPES record last updated: April 13, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Dr. Rafael Villicana Md NPPES

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

DR. RAFAEL VILLICANA MD (NPI 1669496832) is an individual nephrology provider in Loma Linda, California, licensed in California (A83031) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of Michigan State University College Of Human Medicine (2000).

NPPES Registry Identity

NPI1669496832

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameDR. RAFAEL VILLICANACredential: MD

Location Address25865 BARTON RD, SUITE 101Loma Linda, CA 92354-3895

Mailing Address25865 Barton Road, Suite 101Loma Linda, CA 92354 · (909) 558-3636 · Fax (909) 558-3722

Phone(909) 558-3636

Fax(909) 558-3722

Sole ProprietorNo

Medical School CMSMichigan State University College Of Human MedicineGraduated 2000

Enumeration DateJuly 27, 2006

Last NPPES UpdateApril 13, 2016

✔ NPI 1669496832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in CA · A83031

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

25865 BARTON RD, Loma Linda, CA 92354

Open in Google Maps ↗

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. Rafael Villicana Md 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 ID5597667691

PECOS Enrollment IDI20061212000648

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 5

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.

Follow-up hospital inpatient care per day, typically 35 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.

347 services84 patients

Established patient office or other outpatient visit, 40-54 minutes 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.

291 services98 patients

Established patient office or other outpatient visit, 30-39 minutes 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.

145 services99 patients

Initial hospital inpatient care per day, typically 70 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

58 services54 patients

Telephone medical discussion with physician, 21-30 minutes 99443

This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.

20 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92354 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

$136.04 typical visit price

range $59.60 – $179.42

Typical copayment $34.01 (range $14.90 – $44.85)

Most-billed visit code 99204

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

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.

85.18/100

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

Scored as part of a group practice

Quality

71.81

Promoting Interoperability

Improvement Activities

Cost

64.54

Reported Quality Measures

Medication Reconciliation Post-Discharge

The percentage of discharges from any inpatient facility (e.g. hospital, skilled nursing facility, or rehabilitation facility) for patients 18 years and older of age seen within 30 days following discharge in the office by the physician, prescribing…

100%24 patients

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

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

100%180 patients5/55-star benchmark: 100%

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

Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

100%186 patients5/55-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 11

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

Azathioprine, oral, 50 mg J7500