Individual provider Active NPI

Celeste Erika Valencia, M.D.

  • Psychiatry Physician
  • New Haven, CT
National Provider Identifier
1013273317
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
S2186 Issued in TX
Practice address
34 Park St
New Haven, CT 06519-1109
Phone
(203) 974-7158
NPI assigned
Apr 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036.150877 IL
Psychiatry Physician 2084P0800X 11758 SD
Psychiatry Physician 2084P0800X 054915 CT
Psychiatry Physician 2084P0800X S2186 TX Primary

Addresses

Primary practice location

34 Park St
New Haven, CT 06519-1109

Mailing address

4525 N Ravenswood Ave
Ste 201
Chicago, IL 60640-5201
Phone (312) 857-8794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191227000664 TX Practitioner - Psychiatry 8325333826 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
054915CTMDPsychiatry Physician
036.150877ILMDPsychiatry Physician
11758SDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Psychiatry CurrentSince Mar 26, 2021 Accepting new patients
Tri-County Clinical Current Accepting new patients
Tri-County Clinical CurrentSince Mar 1, 2023 Accepting new patients
Ascension Seton Past Accepting new patients
Flandreau Santee Sioux Tribe PastSince May 31, 2020 Accepting new patients

Locations

5401 N Knoxville Ave
Ste 204
Peoria, IL 61614
Phone (309) 683-1200

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A1
Peoria, IL 61602

900 Main St
Ste 400
Peoria, IL 61602
Phone (309) 671-3100

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

Interoperability endpoints

  • Direct secure messaging: celeste.valencia.1@8363.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1013273317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 N RAVENSWOOD AVE",
            "address_2": "STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405201",
            "telephone_number": "312-857-8794",
            "fax_number": "708-575-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191109",
            "telephone_number": "203-974-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "CELESTE",
        "middle_name": "ERIKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.150877",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "11758",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "054915",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "S2186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.