ISRAEL J VILLANUEVA MATOS MD
NPI 1780232033
General Practice in Aguada, PR
NPI Status: Active since August 29, 2019
Contact Information
B5 URB SAN CRISTOBAL
AGUADA, PR
ZIP 00602
Phone: (787) 868-2803
- Individual
- Male
- Years of Experience 16
- General Practice
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About ISRAEL VILLANUEVA MATOS
This page provides the complete NPI Profile along with additional information for Israel Villanueva Matos, a primary care provider established in Aguada, Puerto Rico with a medical specialization in General Practice and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1780232033 assigned on August 2019. The practitioner's primary taxonomy code is 208D00000X with license number 21548 (PR). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1780232033
- Provider Name
- ISRAEL J VILLANUEVA MATOS MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- B5 URB SAN CRISTOBAL AGUADA, PR 00602
- Location Phone
- (787) 868-2803
- Mailing Address
- B5 URB SAN CRISTOBAL AGUADA, PR 00602
- Mailing Phone
- (787) 868-2803
- Medical School Name
- OTHER
- Graduation Year
- 2010
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-29-2019
- Last Update Date
- 01-22-2025
- Code Navigator
A primary care provider (PCP) like Israel Villanueva Matos sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Practice
- Taxonomy Code
- 208D00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 21548
- License State
- PR
- Taxonomy Description
- A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Connect Bronze 0 Indiv Med Deductible - EPO
- Connect Bronze 5500 Indiv Med Deductible - EPO
- Connect Bronze 6500 Indiv Med Deductible Enhanced Diabetes Care - EPO
- Connect Bronze CMS Standard - EPO
- Connect Gold 2000 Indiv Med Deductible - EPO
- Connect Gold 800 Indiv Med Deductible - EPO
- Connect Gold CMS Standard - EPO
- Connect Silver 3600 Indiv Med Deductible - EPO
- Connect Silver 4300 Indiv Med Deductible - EPO
- Connect Silver CMS Standard - EPO
- Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
- Bronze 1826 + Adult Dental + Adult Vision ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
- Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access) - HMO
- Bronze Savings 1820 + Adult Dental + Adult Vision (Primary Care Copay Visits 1-5, Open Access) - HMO
- Bronze Standard 1828 - HMO
- Bronze Value 1814 (High Value Network Savings, Open Access) - HMO
- Bronze Value 1814 + Adult Dental + Adult Vision (High Value Network Savings, Open Access) - HMO
- Catastrophic 1746 (Primary Care Copay Visits 1-3, Open Access) - HMO
- Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
- Gold 1742 + Adult Dental + Adult Vision (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
- Gold Savings 1825 ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
- Gold Savings 1825 + Adult Dental + Adult Vision ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
- Gold Standard 1833 - HMO
- Gold Value 1819 ($1,300 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
- Gold Value 1819 + Adult Dental + Adult Vision ($1,300 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
- Silver 1664 (Primary Care & Specialist Copays, Open Access) - HMO
- Silver 1664 + Adult Dental + Adult Vision (Primary Care & Specialist Copays, Open Access) - HMO
- Silver Savings 1821 (Primary Care Copay, Open Access) - HMO
- Silver Savings 1821 + Adult Dental + Adult Vision (Primary Care Copay, Open Access) - HMO
- Silver Standard 1829 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Gold Elite Saver Plus - EPO
- Secure - EPO
- Silver Classic Standard - EPO
- Silver Elite - EPO
- Silver Simple Chronic Care CKM - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
- Wellpoint Essential Bronze 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 5500 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Catastrophic 9200 (+ Incentives) - HMO
- Wellpoint Essential Gold 1400 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 800 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 5000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Israel Villanueva Matos is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Israel Villanueva Matos is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 2769810654
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20220525000265
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
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.
This service was performed 58 times for 36 patientsThis 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.
This service was performed 19 times for 15 patientsReviews for ISRAEL J VILLANUEVA MATOS MD
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 7 | 8 | 0 | 2 | 3 | 2 | 0 | 3 | 3 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 7 | 16 | 0 | 4 | 3 | 4 | 0 | 6 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 7 + 1 + 6 + 0 + 4 + 3 + 4 + 0 + 6 + 24 = 57 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
60 - 57 = 3 | 3 |
The NPI number 1780232033 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780232033, enumerated as an "individual" on August 29, 2019.
The provider is located at B5 URB SAN CRISTOBAL AGUADA, PR 00602 and the phone number is (787) 868-2803.
General Practice with taxonomy code 208D00000X.
The provider might be accepting Accepts: Cigna Healthcare, Health First Commercial Plans,. Please consult your insurance carrier or call the provider to verify.