Individual provider Active NPI

Rudolph P. Valentini, M.D.

  • Pediatric Nephrology Physician
  • Detroit, MI
National Provider Identifier
1164463600
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
4301060863 Issued in MI
Practice address
Childrens Hospital of Michigan
3901 Beaubien Blvd - Nephrology
Detroit, MI 48201
Phone
(313) 745-5604
Fax
(313) 966-0039
NPI assigned
Jun 8, 2006
Last updated
Jan 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 4301060863 MI Primary

Addresses

Primary practice location

Childrens Hospital of Michigan
3901 Beaubien Blvd - Nephrology
Detroit, MI 48201

Mailing address

4201 St. Antoine - Uhc 5D Mailbox 226
University Pediatricians
Detroit, MI 48201-2153
Phone (313) 745-4405

Other identifiers 4

IdentifierTypeStateIssuer
700H262280OtherBLUE CROSS-BLUE CROSS
RV060863OtherCHAMPUS-CHAMPUS
RV060863OtherCOMMERCIAL-COMMERCIAL NUMBER
339919310MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20070108000029 MI Practitioner - NephrologyPractitioner - Pediatric Medicine 6002816592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Pediatric Medicine
Education
Wayne State University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University PediatriciansGroup PAC ID 9638070568, 121 clinicians

Practice addresses (Care Compare)

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-5870

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301060863MIMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians CurrentSince Jul 1, 1998 Accepting new patients
University Pediatricians CurrentSince Jul 1, 1998 Accepting new patients
University Pediatricians Current Accepting new patients
VHS Childrens Hospital of Michigan Inc Past Accepting new patients

Locations

42700 Garfield Rd
Ste 100
Clinton Twp, MI 48038
Phone (586) 532-3401

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3950 Beaubien St
Fl 3
Detroit, MI 48201
Phone (313) 832-8550

Interoperability endpoints

  • Direct secure messaging: rvalenti@direct.dmc.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484870400000",
    "number": "1164463600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE - UHC 5D MAILBOX 226",
            "address_2": "UNIVERSITY PEDIATRICIANS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4405",
            "fax_number": "313-966-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHILDRENS HOSPITAL OF MICHIGAN",
            "address_2": "3901 BEAUBIEN BLVD - NEPHROLOGY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-5604",
            "fax_number": "313-966-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTINI",
        "first_name": "RUDOLPH",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2017-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "MI",
            "license": "4301060863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS-BLUE CROSS",
            "identifier": "700H262280",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "RV060863",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "RV060863",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339919310",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.