Individual provider Active NPI

Robert Valdes, PTA

  • Physical Therapy Assistant
  • Scottsdale, AZ
National Provider Identifier
1104389543
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-008617 Issued in AZ
Practice address
3293 N Drinkwater Blvd
Scottsdale, AZ 85251-6405
Phone
(480) 947-7443
NPI assigned
Apr 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-008617 AZ Primary

Addresses

Primary practice location

3293 N Drinkwater Blvd
Scottsdale, AZ 85251-6405

Mailing address

2119 E Bishop Dr
Tempe, AZ 85282-2916
Phone (602) 790-5520

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA-008617AZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1104389543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 E BISHOP DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822916",
            "telephone_number": "602-790-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3293 N DRINKWATER BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516405",
            "telephone_number": "480-947-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "ROBERT",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA-008617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.