Active NPI
Pio Valenzuela II, MD
- Plastic Surgery Physician
- Pittsburgh, PA
National Provider Identifier
1245336395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 24905
- Practice address
- 107 Gamma Drive
Suite 210
Pittsburgh, PA 15238-2936 - Phone
- (412) 963-6677
- Fax
- (412) 963-6868
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 4301042756 | MI | |
| Plastic Surgery Physician | 208200000X | 24905 | KY | Primary |
Addresses
Primary practice location
107 Gamma Drive
Suite 210
Pittsburgh, PA 15238-2936
Mailing address
107 Gamma Drive
Suite 210
Pittsburgh, PA 15238-2936
Phone (412) 963-6677
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4847125 | Medicaid | MI | |
| 2403312691 | Other | MI | BCBS INDIVIDUAL PIN |
| 7100244120 | Medicaid | KY | |
| 03206104 | Medicaid | NY | |
| 1024359950001 | Medicaid | PA | |
| 200000001285 | Other | MI | PHP PIN # |
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
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429488000000",
"number": "1245336395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 GAMMA DRIVE",
"address_2": "SUITE 210",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152382936",
"telephone_number": "412-963-6677",
"fax_number": "412-963-6868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 GAMMA DRIVE",
"address_2": "SUITE 210",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152382936",
"telephone_number": "412-963-6677",
"fax_number": "412-963-6868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENZUELA",
"first_name": "PIO",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2015-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "MI",
"license": "4301042756",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "KY",
"license": "24905",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4847125",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS INDIVIDUAL PIN",
"identifier": "2403312691",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100244120",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03206104",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1024359950001",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHP PIN #",
"identifier": "200000001285",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.