Dr Omar Mijael Villarroel Fernandez, MD in Rockford, IL

Dr Omar Mijael Villarroel Fernandez, MD is a medicare enrolled "Pediatrics" physician in Rockford, Illinois. His current practice location is 1401 E State St, 3rd Floor, Rockford, Illinois. You can reach out to his office (for appointments etc.) via phone at (912) 658-1155.

Dr Omar Mijael Villarroel Fernandez is licensed to practice in Missouri (license number 2018018492) 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 1457325334.

Contact Information

	Dr Omar Mijael Villarroel Fernandez, MD
	1401 E State St, 3rd Floor, Rockford, IL 61104-2315
	(912) 658-1155
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Omar Mijael Villarroel Fernandez
Gender	Male
Speciality	Pediatrics
Location	1401 E State St, Rockford, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457325334
Provider Enumeration Date: 02/15/2006
Last Update Date: 08/11/2022

Medicare PECOS Information:

PECOS PAC ID: 7719204403
Enrollment ID: I20150317001555

Medical Identifiers

Medical identifiers for Dr Omar Mijael Villarroel Fernandez such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457325334	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208M00000X	Hospitalist	058592 (Georgia)	Secondary
208M00000X	Hospitalist	036117065 (Illinois)	Secondary
208M00000X	Hospitalist	M-16558 (Idaho)	Secondary
208000000X	Pediatrics	2018018492 (Missouri)	Primary
208000000X	Pediatrics	2008-01887 (North Carolina)	Secondary
208000000X	Pediatrics	MD2005-0619 (New Mexico)	Secondary
208000000X	Pediatrics	058592 (Georgia)	Secondary
208000000X	Pediatrics	036117065 (Illinois)	Secondary
208M00000X	Hospitalist	2018018492 (Missouri)	Secondary

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. Dr Omar Mijael Villarroel Fernandez allows following entities to bill medicare on his behalf.

Entity Name	Vidant Medical Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445

Entity Name	Outer Banks Professional Services, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891050357 PECOS PAC ID: 3173652096 Enrollment ID: O20100602000156

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. Dr Omar Mijael Villarroel Fernandez 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
Dr Omar Mijael Villarroel Fernandez, MD 200 Corporate Blvd, Lafayette, LA 70508-3870 Ph: (800) 893-9698	Dr Omar Mijael Villarroel Fernandez, MD 1401 E State St, 3rd Floor, Rockford, IL 61104-2315 Ph: (912) 658-1155

Reviews and Comments

Pediatrics Doctors in Rockford, IL

Dr. Karen J Dyer, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1401 E State St, Rockford, IL 61104 Phone: 779-696-4400
Dr. Thomas Danko, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1401 E State St, Rockford, IL 61104 Phone: 779-696-4400
Dr. Gary Patrick Fernando, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1200 W State St, Rockford, IL 61102 Phone: 815-490-1600
Kimberly Remedios-smith, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2400 N Rockton Ave, Rockford, IL 61103 Phone: 815-971-5000 Fax: 815-968-5742
Dr. Errol Christopher Baptist, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 461 N Mulford Rd, Suite # 4, Rockford, IL 61107 Phone: 779-696-5570
Patricia L. Moody, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2780 Mcfarland Rd, Rockford, IL 61107 Phone: 815-971-2000 Fax: 815-637-0400
Dr. Gail Sharon Haiken, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5303 Regents Park Rd, Rockford, IL 61107 Phone: 815-397-2528

Dr Omar Mijael Villarroel Fernandez, MD - Medicare Pediatrics in Rockford, IL