Individual provider Active NPI

Valery Medina, OD

  • Optometrist
  • Berkeley, CA
National Provider Identifier
1144924804
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT35640-TLG Issued in CA
Practice address
200 Minor Hall
Berkeley, CA 94720-4501
Phone
(510) 642-6123
NPI assigned
Mar 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X OPT35640-TLG CA Primary
Corneal and Contact Management Optometrist 152WC0802X ATI4672 OR

Addresses

Primary practice location

200 Minor Hall
Berkeley, CA 94720-4501

Mailing address

66 Emery Bay Dr
Emeryville, CA 94608-2920
Phone (949) 887-2985

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828002850 CA Practitioner - Optometry 6002279569 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of California - School of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of California at BerkeleyGroup PAC ID 8628083110, 57 clinicians
UCSF Medical Group Business ServicesGroup PAC ID 3779497870, 1,533 clinicians
Alameda Health SystemGroup PAC ID 3779494521, 597 clinicians

Practice addresses (Care Compare)

200 Minor Hall
Suite 384a
Berkeley, CA 94720-2020
Phone (510) 642-2020

3100 San Pablo Ave
Berkeley, CA 94702-2498
Phone (510) 985-5020

400 Parnassus Ave
San Francisco, CA 94143-2202

664 Southland Mall
Hayward, CA 94545-2150
Phone (510) 266-1700

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4672ORMDDentist
OPT35640-TLGCAMDOptometrist
ATI4672ORMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of California San Francisco CurrentSince Dec 3, 2024 Accepting new patients
Regents of the University of California CurrentSince Dec 3, 2024 Accepting new patients
Alameda Health System CurrentSince Aug 31, 2024 Accepting new patients
Alameda Health System Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Dec 3, 2024 Accepting new patients
University of California San Francisco CurrentSince Dec 3, 2024 Accepting new patients
UCSF Medical Group Business Services CurrentSince Dec 3, 2024 Accepting new patients
Regents of the University of California at Berkeley Optometrist CurrentSince Sep 12, 2024 Accepting new patients
Alameda Health System CurrentSince Aug 31, 2024 Accepting new patients

Locations

200 Minor Hall
Berkeley, CA 94720
Phone (510) 642-0945

200 Minor Hall
Ste 384A
Berkeley, CA 94720
Phone (510) 642-7844

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

664 Southland Mall
Hayward, CA 94545
Phone (510) 266-1700

6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

Organizations & group practices 9

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": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1144924804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 EMERY BAY DR",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082920",
            "telephone_number": "949-887-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MINOR HALL",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947204501",
            "telephone_number": "510-642-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "VALERY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT35640-TLG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OR",
            "license": "ATI4672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.