Individual provider Active NPI

Yolanda Rodriguez-Valdivia, MD

  • Family Medicine Physician
  • Pocatello, ID
National Provider Identifier
1093701351
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M10385 Issued in ID
Practice address
2850 Olympus Dr
Pocatello, ID 83201
Phone
(208) 239-3815
Fax
(218) 239-3814
NPI assigned
Sep 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M10385 ID Primary

Addresses

Primary practice location

2850 Olympus Dr
Pocatello, ID 83201

Mailing address

2850 Olympus Dr
Pocatello, ID 83201
Phone (208) 239-3815

Other identifiers 2

IdentifierTypeStateIssuer
807241700MedicaidID
1093701351MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20110615000193 ID Practitioner - Family Practice 9638356835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M10385IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Hospital LLC Current Accepting new patients
Pocatello Health Services, LLC Current Accepting new patients
Pocatello Health Services, LLC CurrentSince Oct 1, 2013 Accepting new patients
Pocatello Health Services, LLC CurrentSince Oct 1, 2013 Accepting new patients
Health West, Inc. Past Accepting new patients

Locations

465 Memorial Dr
Pocatello, ID 83201
Phone (208) 234-4700

2850 Olympus Dr
Pocatello, ID 83201
Phone (208) 239-2273

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

500 S 11th Ave
Ste 303
Pocatello, ID 83201
Phone (208) 234-2300

Interoperability endpoints

  • Direct secure messaging: yrodriguezvaldivia179532@ahs.direct-ci.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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1093701351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 OLYMPUS DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-239-3815",
            "fax_number": "218-239-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 OLYMPUS DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-239-3815",
            "fax_number": "218-239-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ-VALDIVIA",
        "first_name": "YOLANDA",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2023-12-28",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M10385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807241700",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093701351",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.