Individual provider Active NPI

Lynnette M. Valentijn, M.D.

  • Pediatrics Physician
  • Saginaw, MI
National Provider Identifier
1275524175
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301406348 Issued in MI
Practice address
4684 Wenmar Dr
Saginaw, MI 48604-2817
Phone
(989) 793-1095
NPI assigned
Oct 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301406348 MI Primary

Addresses

Primary practice location

4684 Wenmar Dr
Saginaw, MI 48604-2817

Mailing address

4684 Wenmar Dr
Saginaw, MI 48604-2817
Phone (989) 793-1095

Other identifiers 2

IdentifierTypeStateIssuer
100260460MedicaidIN
000000869274OtherINBCBS BMG PEDIATRICS BRISTOL ST

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

State licenses

LicenseStateTypeSpecialty
4301406348MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Pediatric Partners PC Pediatrics Current Accepting new patients

Locations

4684 Wenmar Dr
Saginaw, MI 48604
Phone (989) 793-1095

Interoperability endpoints

  • Direct secure messaging: lvalentijn155040@direct.aspirus.org
  • Direct secure messaging: lynnettevalentijn@cpppc.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1275524175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4684 WENMAR DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042817",
            "telephone_number": "989-793-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4684 WENMAR DR",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042817",
            "telephone_number": "989-793-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTIJN",
        "first_name": "LYNNETTE",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301406348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100260460",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BMG PEDIATRICS BRISTOL ST",
            "identifier": "000000869274",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.