Organization Active NPI

Humberto Valdes Jr MD PA

  • Psychiatry Physician
  • Exeter, NH
National Provider Identifier
1124483664
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
NH6284 Issued in NH
Legal business name
HUMBERTO VALDES JR MD PA
Practice address
196 Water St
Suite 15
Exeter, NH 03833-2422
Phone
(603) 778-1721
NPI assigned
Dec 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Authorized official

Name
Humberto Valdes Jr., M.D.NPI 1316972268
Title
President
Phone
(603) 778-1721

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X NH6284 NH Primary

Addresses

Primary practice location

196 Water St
Suite 15
Exeter, NH 03833-2422

Mailing address

196 Water St
Suite 15
Exeter, NH 03833-2422
Phone (603) 778-1721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160107002172 NH Part B Supplier - Clinic/Group Practice 4688976665 Receives reassigned benefits from 1 practitioner
Practice locations: Exeter, NH

National Provider Directory

National Provider Directory

Locations

196 Water St
Ste 15
Exeter, NH 03833
Phone (603) 778-1721

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451347200000",
    "number": "1124483664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 WATER ST",
            "address_2": "SUITE 15",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332422",
            "telephone_number": "603-778-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 WATER ST",
            "address_2": "SUITE 15",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332422",
            "telephone_number": "603-778-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBERTO VALDES JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A",
        "authorized_official_last_name": "VALDES",
        "authorized_official_first_name": "HUMBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-778-1721",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "NH6284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.