Individual provider Active NPI

Martha Maria Valdivia, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1083646970
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
198167 Issued in NY
Practice address
629 W 185TH St
New York, NY 10033-3102
Phone
(212) 928-3900
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 198167 NY Primary

Addresses

Primary practice location

629 W 185TH St
New York, NY 10033-3102

Mailing address

8817 5TH Ave
North Bergen, NJ 07047-5229
Phone (201) 453-0659

Other identifiers 1

IdentifierTypeStateIssuer
02734265MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060221000859 NY Practitioner - Internal Medicine 3274549720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Groupo Medico Dominicano PLLCGroup PAC ID 8123125945, 8 clinicians

Practice addresses (Care Compare)

629 W 185TH St
New York, NY 10033-3102
Phone (212) 928-3900

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Groupo Medico Dominicano PLLC CurrentSince Jul 1, 2005 Accepting new patients

Locations

629 W 185th St
Ste 3
New York, NY 10033
Phone (212) 543-3500

629 W 185th St
New York, NY 10033
Phone (212) 543-3500

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083646970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8817 5TH AVE",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475229",
            "telephone_number": "201-453-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 W 185TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100333102",
            "telephone_number": "212-928-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDIVIA",
        "first_name": "MARTHA",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "198167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02734265",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.