Individual provider Active NPI

Ivomny Valdes, PA

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1215302013
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9108949 Issued in FL
Practice address
3661 S Miami Ave
Suite 409
Miami, FL 33133-4236
Phone
(305) 854-5971
Fax
(305) 858-6654
NPI assigned
Dec 4, 2015
Last updated
Dec 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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 PA9108949 FL Primary

Addresses

Primary practice location

3661 S Miami Ave
Suite 409
Miami, FL 33133-4236

Mailing address

15280 NW 79TH CT Ste 200
Miami Lakes, FL 33016-5873
Phone (305) 558-3724

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ivomnyvaldes@sfa.allscriptsdirect.net South Florida ENT Associates, Inc.

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160224002700 FL Practitioner - Physician Assistant 8628373933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida ENT Associates IncGroup PAC ID 4587556923, 156 clinicians

Practice addresses (Care Compare)

3661 S Miami Ave
Suite 409
Miami, FL 33133-4230
Phone (305) 854-5971

8940 N Kendall Dr
Suite 504E
Miami, FL 33176-2150
Phone (305) 595-6200

Merit-based Incentive Payment System (MIPS)

Final score
70.4 of 100Reported as group
Quality
47.82
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: ivomnyvaldes@sfa.allscriptsdirect.net

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, 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": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1215302013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT STE 200",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165873",
            "telephone_number": "305-558-3724",
            "fax_number": "786-907-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3661 S MIAMI AVE",
            "address_2": "SUITE 409",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334236",
            "telephone_number": "305-854-5971",
            "fax_number": "305-858-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "IVOMNY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-04",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ivomnyvaldes@sfa.allscriptsdirect.net",
            "affiliation": "Y",
            "affiliationName": "South Florida ENT Associates, Inc.",
            "address_1": "3661 S Miami Ave",
            "address_2": "Suite 409",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331334236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.