Active NPI
Jose Angel Valdivia, PA-C
- Surgical Physician Assistant
- Sun City, AZ
National Provider Identifier
1053461285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 2145
- Practice address
- 10401 W Thunderbird Blvd
Sun City, AZ 85351-3004 - Phone
- (623) 876-5366
- Fax
- (866) 552-8029
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 2145 | AZ | Primary |
Addresses
Primary practice location
10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Mailing address
10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 876-5366
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 455809 | Medicaid | AZ |
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
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Cardiovascular Center PLC | Surgical | Past | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297641600000",
"number": "1053461285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10401 W THUNDERBIRD BLVD",
"city": "SUN CITY",
"state": "AZ",
"postal_code": "853513004",
"telephone_number": "623-876-5366",
"fax_number": "866-552-8029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10401 W THUNDERBIRD BLVD",
"city": "SUN CITY",
"state": "AZ",
"postal_code": "853513004",
"telephone_number": "623-876-5366",
"fax_number": "866-552-8029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALDIVIA",
"first_name": "JOSE",
"middle_name": "ANGEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2011-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "AZ",
"license": "2145",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "455809",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sun City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.