NPIMap

Individual provider Active NPI

Mauricio Valdes, M.D.

  • Nephrology Physician
  • Yonkers, NY
National Provider Identifier
1215017769
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
216884 Issued in NY
Practice address
136 S Broadway
Yonkers, NY 10701-4008
Phone
(914) 965-0621
Fax
(914) 965-2040
NPI assigned
Oct 17, 2006
Last updated
Sep 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 216884 NY Primary

Addresses

Primary practice location

136 S Broadway
Yonkers, NY 10701-4008

Mailing address

75A Lake Rd 155
Congers, NY 10920-2323
Phone (914) 965-0621

Other identifiers 1

IdentifierTypeStateIssuer
02107385MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060505000727 NY Practitioner - Nephrology 5890706873 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Howard University College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Westchester Nephrology PLLCGroup PAC ID 5395918668, 3 clinicians

Practice addresses (Care Compare)

127 S Broadway
Yonkers, NY 10701-4006
Phone (914) 378-7581

136 S Broadway
Yonkers, NY 10701-4008
Phone (914) 965-0621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
13.68 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
45.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216884NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Westchester Nephrology PLLC Nephrology CurrentSince Feb 21, 2012 Accepting new patients
St. Joseph's Hospital & Medical Center CurrentSince Oct 1, 2012 Accepting new patients
St. Joseph's Hospital Yonkers Current Accepting new patients
St Josephs Hospital Yonkers CurrentSince Oct 1, 2012 Accepting new patients
Rye Family Practice PC Past Accepting new patients

Locations

75 Lake Rd
Ste A
Congers, NY 10920
Phone (914) 729-7999

107 S Broadway
Yonkers, NY 10701
Phone (914) 378-7110

127 S Broadway
Yonkers, NY 10701
Phone (914) 378-7342

136 S Broadway
Yonkers, NY 10701
Phone (914) 965-0621

75 S Broadway
Yonkers, NY 10701
Phone (914) 376-7134

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mauricio.valdes.p1@direct.saintjosephs.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1215017769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75A LAKE RD 155",
            "city": "CONGERS",
            "state": "NY",
            "postal_code": "109202323",
            "telephone_number": "914-965-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107014008",
            "telephone_number": "914-965-0621",
            "fax_number": "914-965-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "MAURICIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "216884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02107385",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.