GABRIEL LEO VILLAVICENCIO MD
NPI 1679374979
Student in an Organized Health Care Education/Training Program in Las Vegas, NV
About Gabriel Leo Villavicencio Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GABRIEL LEO VILLAVICENCIO MD (NPI 1679374979) is an individual student in an organized health care education/training program in Las Vegas, Nevada and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gabriel Leo Villavicencio Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
LAS VEGAS, NV 89154
LAS VEGAS, NV 89154
LAS VEGAS, NV 89154
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 Gabriel Villavicencio's NPI number?
The NPI number for Gabriel Villavicencio is 1679374979. It was assigned to this individual provider in the NPPES registry on March 22, 2025.
Where is Gabriel Villavicencio located?
Gabriel Villavicencio practices at 4505 S Maryland Pkwy, Las Vegas, NV 89154. The listed phone number is (702) 855-3011.
What is Gabriel Villavicencio's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Gabriel Villavicencio enrolled in Medicare?
Yes. Gabriel Villavicencio is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Gabriel Villavicencio was last updated on March 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.
# Gabriel Leo Villavicencio, MD · NPI 1679374979
Student in an Organized Health Care Education/Training Program provider in Las Vegas, Nevada. Individual provider, active in the CMS NPPES registry since March 22, 2025.
## Identity
- **NPI:** 1679374979 (Entity type: Individual)
- **Enumerated:** March 22, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4505 S MARYLAND PKWY, Las Vegas, NV 89154-9900
- **Phone:** (702) 855-3011
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 22, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1679374979) · Data from the CMS NPPES public registry.