Active NPI
Jonathan Aaron Valdez, RDN, CSG, CDN, CDE
- Registered Dietitian
- Astoria, NY
National Provider Identifier
1255963757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 008302-1
- Practice address
- 2110 30TH Ave Apt 1
Astoria, NY 11102-4565 - Phone
- (808) 358-4275
- NPI assigned
- Feb 12, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 008302-1 | NY | Primary |
Addresses
Primary practice location
2110 30TH Ave Apt 1
Astoria, NY 11102-4565
Mailing address
2110 30TH Ave Apt 1
Astoria, NY 11102-4565
Phone (808) 358-4275
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82-1494322 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jon@genki-nutrition.com | Direct |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008302-1 | NY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genki Nutrition | Dietitian, Registered | Current | Accepting new patients |
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 2
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": "1581465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581465600000",
"number": "1255963757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 30TH AVE APT 1",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111024565",
"telephone_number": "808-358-4275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 30TH AVE APT 1",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111024565",
"telephone_number": "808-358-4275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALDEZ",
"first_name": "JONATHAN",
"middle_name": "AARON",
"name_prefix": "Mr.",
"credential": "RDN, CSG, CDN, CDE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-12",
"last_updated": "2020-02-12",
"certification_date": "2020-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "008302-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "82-1494322",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jon@genki-nutrition.com",
"affiliation": "N",
"endpointDescription": "E-mail Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2110 30th Ave Apt 1",
"city": "Astoria",
"state": "NY",
"country_code": "US",
"postal_code": "111024565",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.