Mr Cresolito Alcantara Villanueva Jr, in Stockton, CA

Mr Cresolito Alcantara Villanueva Jr, is a medicare enrolled "Nurse Practitioner - Family" in Stockton, California. His current practice location is 2339 W Hammer Ln, Stockton, California. You can reach out to his office (for appointments etc.) via phone at (209) 940-5901.

Mr Cresolito Alcantara Villanueva Jr is licensed to practice in California (license number 95010695) 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 1083186639.

Contact Information

	Mr Cresolito Alcantara Villanueva Jr,
	2339 W Hammer Ln, Stockton, CA 95209-2368
	(209) 940-5901
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Cresolito Alcantara Villanueva Jr
Gender	Male
Speciality	Nurse Practitioner - Family
Location	2339 W Hammer Ln, Stockton, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083186639
Provider Enumeration Date: 12/20/2018
Last Update Date: 11/11/2021

Medicare PECOS Information:

PECOS PAC ID: 9739594789
Enrollment ID: I20210224002627

Medical Identifiers

Medical identifiers for Mr Cresolito Alcantara Villanueva Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083186639	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95010695 (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. Mr Cresolito Alcantara Villanueva Jr allows following entities to bill medicare on his behalf.

Entity Name	Providence Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285890624 PECOS PAC ID: 8921993205 Enrollment ID: O20040216001346

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. Mr Cresolito Alcantara Villanueva Jr 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
Mr Cresolito Alcantara Villanueva Jr, 2339 W Hammer Ln, Stockton, CA 95209-2368 Ph: (209) 940-5901	Mr Cresolito Alcantara Villanueva Jr, 2339 W Hammer Ln, Stockton, CA 95209-2368 Ph: (209) 940-5901

Reviews and Comments

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Mr Cresolito Alcantara Villanueva Jr, - Medicare Nurse Practitioner in Stockton, CA