Individual provider Active NPI

Pedro Jimenez Valdes, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Anchorage, AK
National Provider Identifier
1053396838
Registry record updated Aug 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
3443 Issued in AK
Practice address
2741 Debarr Rd
Ste C-416
Anchorage, AK 99508-2953
Phone
(907) 258-4430
Fax
(907) 258-4435
NPI assigned
Dec 14, 2005
Last updated
Aug 22, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 3443 AK Primary

Addresses

Primary practice location

2741 Debarr Rd
Ste C-416
Anchorage, AK 99508-2953

Mailing address

PO Box 84564
Seattle, WA 98124-5864
Phone (907) 258-4430

Other identifiers 3

IdentifierTypeStateIssuer
MD1611MedicaidAK
0000WFBKKOtherMCARE ACS GRP
DC1725OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3443AKMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pedro J. Valdes, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince Jan 1, 1994 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345593600000",
    "number": "1053396838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84564",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245864",
            "telephone_number": "907-258-4430",
            "fax_number": "907-258-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2741 DEBARR RD",
            "address_2": "STE C-416",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995082953",
            "telephone_number": "907-258-4430",
            "fax_number": "907-258-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "PEDRO",
        "middle_name": "JIMENEZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2012-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "AK",
            "license": "3443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD1611",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE ACS GRP",
            "identifier": "0000WFBKK",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC1725",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.