Individual provider Active NPI

Amelia Bautista Valdez, M.D.

  • Family Medicine Physician
  • Vallejo, CA
National Provider Identifier
1124053012
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A526260 Issued in CA
Practice address
329 Tennessee St
Vallejo, CA 94590-4450
Phone
(707) 554-1986
Fax
(707) 554-1987
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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 A526260 CA Primary

Addresses

Primary practice location

329 Tennessee St
Vallejo, CA 94590-4450

Mailing address

329 Tennessee St
Vallejo, CA 94590-4450
Phone (707) 554-1986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20041119001085 CA Practitioner - Family PracticePractitioner - Emergency Medicine 7810951035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

329 Tennessee St
Vallejo, CA 94590-4450
Phone (707) 554-1986

Hospital & facility affiliations

  • Sutter Solano Medical Center Hospital, Vallejo, CA, CCN 050101
  • Ahmc Seton Medical Center Hospital, Daly City, CA, CCN 050289
  • Peninsula Medical Center Hospital, Burlingame, CA, CCN 050007
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A526260CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valdez Medical Corp Family Medicine CurrentSince May 9, 2001 Accepting new patients
Solano Regional Medical Group, Inc. Family Medicine PastSince Jun 15, 2006 Accepting new patients

Locations

1800 Sullivan Ave
Rm 408
Daly City, CA 94015
Phone (650) 756-1214

329 Tennessee St
Vallejo, CA 94590
Phone (650) 756-1214

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: avaldez24872@hpmg.direct-ci.net

Organizations & group practices 2

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 6

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1124053012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 TENNESSEE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904450",
            "telephone_number": "707-554-1986",
            "fax_number": "707-554-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 TENNESSEE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945904450",
            "telephone_number": "707-554-1986",
            "fax_number": "707-554-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "AMELIA",
        "middle_name": "BAUTISTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A526260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.