Kevin Villalta, is a medicare enrolled "Social Worker - Clinical" provider in Santa Fe Springs, California. His current practice location is
11721 Telegraph Rd, Santa Fe Springs, California. You can reach out to his office (for appointments etc.) via phone at
(562) 949-8455.
Kevin Villalta is licensed to practice in California (license number 112716) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1790160794.
Healthcare Provider's Profile
Full Name | Kevin Villalta |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 11721 Telegraph Rd, Santa Fe Springs, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1790160794
- Provider Enumeration Date: 07/21/2015
- Last Update Date: 05/24/2023
Medicare PECOS Information:
- PECOS PAC ID: 4284074618
- Enrollment ID: I20240501003533
Medical Identifiers
Medical identifiers for Kevin Villalta such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1790160794 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | ASW71678 (California) | Secondary |
101YM0800X | Counselor - Mental Health | ASW107795 (California) | Secondary |
171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | 112716 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kevin Villalta allows following entities to bill medicare on his behalf.
Entity Name | Grow Healthcare Group Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kevin Villalta is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kevin Villalta, Po Box 93606, City Of Industry, CA 91715-3606 Ph: (818) 577-3892 | Kevin Villalta, 11721 Telegraph Rd, Santa Fe Springs, CA 90670-3674 Ph: (562) 949-8455 |
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