Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Louie Chelle Bacaltos Villamor

Individual provider Physician Assistant · NPI 1497330476

Louie Chelle Bacaltos Villamor is a Physician Assistant in Maplewood, Minnesota. Qualified in 2022, 4 years ago. Practices with Group Health Plan Inc, a 1,633-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
4
Licensed in
MN
In the registry since
2021
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Practice location Address checks out

2165 White Bear Ave N
Maplewood, MN 55109-2707
Phone: (651) 523-9800
Fax: (651) 523-9801
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14164 (MN)

Record details

NPI number1497330476
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 11, 2021
Last updated in NPPESSeptember 12, 2022
Certification dateSeptember 12, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Group Health Plan Inc — 1633 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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