Individual provider Active NPI

Ivan Valodzka

  • Pharmacist
  • Rochester, NY
National Provider Identifier
1124907605
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
073028 Issued in NY
Practice address
2100 Monroe Ave
Rochester, NY 14618-2408
Phone
(585) 461-3995
NPI assigned
Aug 29, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 073028 NY Primary

Addresses

Primary practice location

2100 Monroe Ave
Rochester, NY 14618-2408

Mailing address

24 Mango LN
Rochester, NY 14606-4329
Phone (585) 490-1703

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
073028NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
CVS Albany LLC PastSince Sep 3, 2025 Accepting new patients
CVS Albany LLC PastSince Sep 3, 2025 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1756425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1124907605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 MANGO LN",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146064329",
            "telephone_number": "585-490-1703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MONROE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182408",
            "telephone_number": "585-461-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALODZKA",
        "first_name": "IVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-29",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "073028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2025; 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.