Individual provider Active NPI

Medea Yvonne Valdez, PA-C

  • Physician Assistant
  • Parsippany, NJ
National Provider Identifier
1174048367
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00048900 Issued in NJ
Practice address
190 Baldwin Rd Ste B
Parsippany, NJ 07054-2006
Phone
(973) 882-0444
NPI assigned
Aug 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00048900 NJ Primary

Addresses

Primary practice location

190 Baldwin Rd Ste B
Parsippany, NJ 07054-2006

Mailing address

536 Richard PL
Wyckoff, NJ 07481-1703
Phone (201) 819-1682

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MP00048900NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Occupational Health Centers of New Jersey, PA Past Accepting new patients
American Current Care of New Jersey PA Past 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": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1174048367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 RICHARD PL",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811703",
            "telephone_number": "201-819-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 BALDWIN RD STE B",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070542006",
            "telephone_number": "973-882-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "MEDEA",
        "middle_name": "YVONNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00048900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsippany, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; 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.