Individual provider Active NPI

Michael Lee Vallez, D.P.M.

  • Podiatrist
  • Richfield, MN
National Provider Identifier
1215440854
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1130 Issued in MN
Practice address
6625 Lyndale Ave S Ste 105
Richfield, MN 55423-2673
Phone
(612) 788-8778
Fax
(612) 869-3473
NPI assigned
Nov 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 135.000988 IL
Podiatrist 213E00000X 1130 MN Primary

Addresses

Primary practice location

6625 Lyndale Ave S Ste 105
Richfield, MN 55423-2673

Mailing address

6625 Lyndale Ave S Ste 300
Richfield, MN 55423-2491
Phone (612) 788-8778

Other practice location 1

4646 N Marine Dr
Chicago, IL 60640-5759
Phone (773) 878-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230116000981 MN Practitioner - Podiatry 5294106977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Active Feet, Foot and Ankle Health CenterGroup PAC ID 1254401300, 18 clinicians
In House Senior Services LLCGroup PAC ID 7113170267, 16 clinicians

Practice addresses (Care Compare)

6625 Lyndale Ave S
Suite 105
Richfield, MN 55423-2673
Phone (612) 788-8778

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions16
Removal of nail tissue1614
Removal or shaving of skin growth592
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1130MNMDMarriage & Family Therapist
135.000988ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Active Feet, Foot & Ankle Health Center CurrentSince Jan 1, 2023 Accepting new patients
Active Feet , Foot & Ankle Health Center Podiatrist CurrentSince Jan 1, 2023 Accepting new patients
In House Senior Services, LLC Podiatrist CurrentSince Jan 1, 2023 Accepting new patients

Locations

14000 Nicollet Ave
Ste 306
Burnsville, MN 55337
Phone (952) 435-2629

825 Nicollet Mall
Ste 517
Minneapolis, MN 55402
Phone (612) 332-7720

11500 Highway 7
Ste 201
Minnetonka, MN 55305
Phone (651) 336-8843

6625 Lyndale Ave S
Ste 105
Richfield, MN 55423
Phone (612) 200-8029

6625 Lyndale Ave S
Ste 300
Richfield, MN 55423
Phone (612) 243-8999

4001 Stinson Blvd NE
Ste 120
Saint Anthony, MN 55421

Interoperability endpoints

  • Direct secure messaging: michael.vallez.1@18552.direct.athenahealth.com

Organizations & group practices 3

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": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1215440854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 300",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232491",
            "telephone_number": "612-788-8778",
            "fax_number": "612-869-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 LYNDALE AVE S STE 105",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554232673",
            "telephone_number": "612-788-8778",
            "fax_number": "612-869-3473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4646 N Marine Dr",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606405759",
            "country_code": "US",
            "telephone_number": "773-878-8700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLEZ",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-06",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "135.000988",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MN",
            "license": "1130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

Verify at the official NPI Registry.