| Ian A Villanueva, MD | |
|
208 Ashville Ave, Suite 14, Cary, NC 27518-6678 | |
| (919) 350-9625 | |
| (919) 851-6757 |
| Full Name | Ian A Villanueva |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 23 Years |
| Location | 208 Ashville Ave, Cary, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225256076 | NPI | - | NPPES |
| N0057H | Other | SC | MEDICAID |
| 1225256076 | Medicaid | NC | |
| 200585090A | Medicaid | KS | |
| 5907030 | Medicaid | NC | |
| N0057H | Medicaid | SC | |
| 107539 | Other | KS | BLUE CROSS OF KANSAS |
| 145WE | Other | NC | NCBCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 04-33427 (Kansas) | Secondary |
| 208600000X | Surgery | 2007-00579 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wakemed, Raleigh Campus | Raleigh, NC | Hospital |
| Wakemed, Cary Hospital | Cary, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wakemed Specialists Group Llc | 2466788377 | 774 |
| Entity Name | Wakemed Specialists Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588227839 PECOS PAC ID: 2466788377 Enrollment ID: O20190731000815 |
| Mailing Address | Practice Location Address |
|---|---|
| Ian A Villanueva, MD 2920 Highwoods Blvd, Raleigh, NC 27604-0010 Ph: (877) 498-4490 | Ian A Villanueva, MD 208 Ashville Ave, Suite 14, Cary, NC 27518-6678 Ph: (919) 350-9625 |
Dr. Kimberly Sue Jones, MD Surgery Medicare: Medicare Enrolled Practice Location: 2395 Kildaire Farm Rd, Cary, NC 27518 Phone: 919-342-9844 | |
Elizabeth Menzel Crocker, MPAS, PA-C Surgery Medicare: Accepting Medicare Assignments Practice Location: 210 Ashville Ave, Cary, NC 27518 Phone: 919-350-7331 | |
Hannah Leigh Goodrum, PA-C Surgery Medicare: Accepting Medicare Assignments Practice Location: 210 Ashville Ave, Cary, NC 27518 Phone: 919-350-9355 Fax: 919-851-6757 | |
Dr. Eric David Duberman, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 155 Parkway Office Ct, Cary, NC 27518 Phone: 919-859-4747 Fax: 919-859-4757 | |
Sindi Diko, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 210 Ashville Ave, Cary, NC 27518 Phone: 919-350-7331 Fax: 919-350-9808 | |
David M Pilati, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 160 Macgregor Pines Dr, Suite 310, Cary, NC 27511 Phone: 919-234-4468 Fax: 919-313-1276 |