RAPHAEL VILLAVICENCIO MD
NPI 1780643627
Hospitalist in Indianapolis, IN
NPI Status: Active since March 20, 2006
Contact Information
1481 W 10TH ST
MEDICINE SERVICE, 111
INDIANAPOLIS, IN
ZIP 46202
Phone: (317) 554-0000
- Individual
- Male
- Years of Experience 33
- Hospitalist
- Accepts Medicare Approved Payment
- PECOS Enrolled
About RAPHAEL VILLAVICENCIO
This page provides the complete NPI Profile along with additional information for Raphael Villavicencio, a provider established in Indianapolis, Indiana with a medical specialization in Hospitalist and more than 33 years of experience. He graduated from Baylor College Of Medicine in 1993. The healthcare provider is registered in the NPI registry with number 1780643627 assigned on March 2006. The practitioner's primary taxonomy code is 208M00000X with license number 01051969A (IN). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1780643627
- Provider Name
- RAPHAEL VILLAVICENCIO MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1481 W 10TH ST MEDICINE SERVICE, 111 INDIANAPOLIS, IN 46202
- Location Phone
- (317) 554-0000
- Mailing Address
- 1481 W 10TH ST MEDICINE SERVICE, 111 INDIANAPOLIS, IN 46202
- Mailing Phone
- (317) 554-0000
- Medical School Name
- BAYLOR COLLEGE OF MEDICINE
- Graduation Year
- 1993
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-20-2006
- Last Update Date
- 12-03-2010
- Code Navigator
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
Hospitalist
- Taxonomy Code
- 208M00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 01051969A
- License State
- IN
- Taxonomy Description
- Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
9397565 | OTHER (01) | IN | PHCS PID NUMBER |
815500G8 | MEDICARE PIN (08) | IN | |
000000351160 | OTHER (01) | IN | ANTHEM PROVIDER NUMBER |
H24565 | MEDICARE UPIN (02) | IN | |
815469VVV | MEDICARE PIN (08) | IN | |
200300450 | MEDICAID (05) | IN | |
P00162690 | MEDICARE PIN (08) | IN |
Medicare Participation & PECOS Enrollment Status
Raphael Villavicencio 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.
Raphael Villavicencio 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: 3971594631
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: I20040520001329
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
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $30.62 for a new patient copayment and $23.55 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 46202 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $122.49
- Minimum New Patient Price $53.07
- Maximum New Patient Price $161.76
- Average New Patient Copayment $30.62
- Minimum New Patient Copayment $13.26
- Maximum New Patient Copayment $40.44
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.22
- Minimum Established Patient Price $16.93
- Maximum Established Patient Price $132.22
- Average Established Patient Copayment $23.55
- Minimum Established Patient Copayment $4.23
- Maximum Established Patient Copayment $33.05
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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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 | 6 | 4 | 3 | 6 | 2 | 7 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 7 | 16 | 0 | 12 | 4 | 6 | 6 | 4 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 7 + 1 + 6 + 0 + 1 + 2 + 4 + 6 + 6 + 4 + 24 = 63 | |||||||||
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
70 - 63 = 7 | 7 |
The NPI number 1780643627 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
NPI | Name / Type | Taxonomy | Address |
---|---|---|---|
1902808934 | DR. RICHA GUPTA M.D. Individual | Hospitalist | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 988-2501 |
1467416826 | LOIS BUSCHBACHER M.D. Individual | Physical Medicine & Rehabilitation | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 988-3385 |
1790740017 | MARK A DEEG M.D. Individual | Internal Medicine (Endocrinology, Diabetes & Metabolism) | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 274-0550 |
1073578530 | ARUNA SANNUTI M.D. Individual | Internal Medicine (Pulmonary Disease) | 1481 W 10TH ST 111P INDIANAPOLIS, IN 46202 (317) 988-3811 |
1538126180 | MARGARET A O'GRADY NP Individual | Nurse Practitioner | 1481 W 10TH ST C&P INDIANAPOLIS, IN 46202 (317) 988-3691 |
1992762199 | DR. BRIAN ALAN PATTERSON D.P.M. Individual | Podiatrist | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0000 |
1144288325 | DR. KENNETH HILLARY GWIRTZ M.D. Individual | Anesthesiology | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0000 |
1437107950 | DR. SANJAY GUPTA Individual | Anesthesiology | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0000 |
1689622136 | MS. AMY LYNN PARPART RN, NP Individual | Nurse Practitioner (Family) | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0000 |
1376592642 | DR. KRISCINDA ANN WHITNEY PH.D. Individual | Clinical Neuropsychologist | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 988-2006 |
1851340137 | MRS. JEANINE HOOTS NP Individual | Nurse Practitioner (Adult Health) | 1481 W 10TH ST ROUTING 118 INDIANAPOLIS, IN 46202 (317) 554-0000 |
1427007475 | DR. FREDERICK PIKE RAUSCHER M.D. Individual | Psychiatry & Neurology (Psychiatry) | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0000 |
1255381679 | JOHN GROMER D.D.S. Individual | Dentist (General Practice) | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0000 |
1295785517 | DR. BRUCE HERBERT WHITLEY MD Individual | Internal Medicine | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0000 |
1467402180 | DR. CHRISTINE M LO D.O. Individual | Anesthesiology | 1481 W 10TH ST DEPT. OF ANESTHESIOLOGY INDIANAPOLIS, IN 46202 (317) 554-0000 |
1396795126 | DR. THOMAS MICHAEL LYNCH M.D. Individual | Internal Medicine | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0000 |
1326099755 | AZARIAS SHAMUS LONBERGER M.D. Individual | Internal Medicine | 1481 W 10TH ST MEDICINE 111 INDIANAPOLIS, IN 46202 (317) 554-0181 |
1073564258 | GEORGE ANDREW SAROSI M.D. Individual | Internal Medicine | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0181 |
1619929106 | MRS. LYNNE S REEVES APRN, BC Individual | Nurse Practitioner | 1481 W 10TH ST INDIANAPOLIS, IN 46202 (317) 554-0000 |
1215980651 | MADDAMSETTI NAGESWARA RAO M.D. Individual | Internal Medicine | 1481 W 10TH ST MEDICINE 111 INDIANAPOLIS, IN 46202 (317) 554-0181 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780643627, enumerated in the NPI registry as an "individual" on March 20, 2006
The provider is located at 1481 W 10th St Medicine Service, 111 Indianapolis, In 46202 and the phone number is (317) 554-0000
The provider's speciality is Hospitalist with taxonomy code 208M00000X
The provider has more than 33 years of experience. He graduated from Baylor College Of Medicine in 1993.
The provider might be accepting Accepts: Private Healthcare Systems (PHCS), Medicare,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.
Medicare beneficiaries should expect a typical cost of $122.49 with an average copayment of $30.62 for new patient appointments. Established patients should expect a typical charge of $94.22 and an average copayment of 23.55. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on March 20, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.