Individual provider Active NPI

Valentina Doumanian, MD

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1205882693
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R6384 Issued in TX
Practice address
3500 Gaston Ave
Dallas, TX 75246-2088
Phone
(214) 820-0111
NPI assigned
May 26, 2006
Last updated
Jun 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 63405 MN
Psychiatry Physician 2084P0800X MD187279 OR
Psychiatry Physician 2084P0800X MD60839274 WA
Psychiatry Physician 2084P0800X 2019010503 MO
Psychiatry Physician 2084P0800X 36524 IA
Psychiatry Physician 2084P0800X 86-320 WI
Psychiatry Physician 2084P0800X R6384 TX Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2088

Mailing address

151 175TH Ave E
Redington Shores, FL 33708-1207
Phone (515) 779-6746

Other practice location 1

1015 NW 22nd Ave
Portland, OR 97210-3025
Phone (503) 413-7711

Other practice location 2

2211 NE 139th St
Vancouver, WA 98686-2742
Phone (360) 487-1000

Other practice location 3

1629 E Division St
River Falls, WI 54022-1571
Phone (715) 307-6000

Other practice location 4

2505 Mission Dr
Jefferson City, MO 65109-9508
Phone (573) 681-3000

Other practice location 5

700 S Park St
Madison, WI 53715-1830
Phone (608) 251-6100

Other practice location 6

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone (763) 236-6000

Other identifiers 1

IdentifierTypeStateIssuer
0487256MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, TX, NY, FL, PA5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20180517001795 OR Practitioner - Psychiatry 8527063098 Reassigns benefits to 1 organization
I20180605001639 TX Practitioner - Psychiatry 8527063098 Reassigns benefits to 1 organization
I20220119001982 NY Practitioner - Psychiatry 8527063098 Reassigns benefits to 1 organization
I20220802003282 FL Practitioner - Psychiatry 8527063098 Reassigns benefits to 2 organizations
I20230208000808 PA Practitioner - Psychiatry 8527063098 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36524IAMDPsychiatry Physician
63405MNMDPsychiatry Physician
2019010503MOMDPsychiatry Physician
MD187279ORMDPsychiatry Physician
R6384TXMDPsychiatry Physician
86-320WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 1, 2023 Accepting new patients
Legacy Clinics LLC CurrentSince Jun 1, 2018 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

1301 Riverplace Blvd
Jacksonville, FL 32207

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

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2418 E York St
Philadelphia, PA 19125
Phone (215) 575-5906

1400 N Coit Rd
Ste 302
McKinney, TX 75071
Phone (214) 945-3640

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1205882693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 175TH AVE E",
            "city": "REDINGTON SHORES",
            "state": "FL",
            "postal_code": "337081207",
            "telephone_number": "515-779-6746",
            "fax_number": "512-838-4264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462088",
            "telephone_number": "214-820-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 NW 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972103025",
            "country_code": "US",
            "telephone_number": "503-413-7711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2211 NE 139th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986862742",
            "country_code": "US",
            "telephone_number": "360-487-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1629 E Division St",
            "address_purpose": "LOCATION",
            "city": "River Falls",
            "state": "WI",
            "postal_code": "540221571",
            "country_code": "US",
            "telephone_number": "715-307-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2505 Mission Dr",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "651099508",
            "country_code": "US",
            "telephone_number": "573-681-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 S Park St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537151830",
            "country_code": "US",
            "telephone_number": "608-251-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4050 Coon Rapids Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Coon Rapids",
            "state": "MN",
            "postal_code": "554332522",
            "country_code": "US",
            "telephone_number": "763-236-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUMANIAN",
        "first_name": "VALENTINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "63405",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD187279",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60839274",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2019010503",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "36524",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "86-320",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "R6384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0487256",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.