Individual provider Active NPI

Vanessa Valdes, MD

  • Psychiatry Physician
  • Miami, FL
National Provider Identifier
1164051181
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
166385 Issued in FL
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(561) 598-2592
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 166385 FL Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

1695 NW 9TH Ave Ste 3100
Miami, FL 33136-1409

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241127000147 FL Practitioner - Psychiatry 2264967389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Miami, LM Miller School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

1301 Riverplace Blvd
Suite 800
Jacksonville, FL 32207-9032
Phone (833) 351-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166385FLMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 6, 2025 Accepting new patients

Locations

1301 Riverplace Blvd
Jacksonville, FL 32207

1301 Riverplace Blvd
Ste 800
Jacksonville, FL 32207
Phone (904) 567-6040

Organizations & group practices 1

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1164051181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1695 NW 9TH AVE STE 3100",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "561-598-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "VANESSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "166385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.