NPIMap

Individual provider Active NPI

Rolando Gabriel Valenzuela, M.D.

  • Emergency Medicine Physician
  • Stony Brook, NY
National Provider Identifier
1275794885
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME160487 Issued in FL
Practice address
HSC Level 4 RM 080
Department of Emergency Medicine
Stony Brook, NY 11794
Phone
(631) 444-2478
Fax
(323) 226-6465
NPI assigned
Jun 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A121092 CA
Emergency Medicine Physician 207P00000X NJ
Emergency Medicine Physician 207P00000X 2883733 NY
Emergency Medicine Physician 207P00000X 53074 TN
Emergency Medicine Physician 207P00000X ME160487 FL Primary

Addresses

Primary practice location

HSC Level 4 RM 080
Department of Emergency Medicine
Stony Brook, NY 11794

Mailing address

436 SW 15TH Rd
Miami, FL 33129-1011
Phone (917) 439-1662

Other practice location 1

1611 NW 12th Ave Dept Of
Miami, FL 33136-1096
Phone (917) 439-1662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160614001810 NY Practitioner - Emergency Medicine 6305071770 Reassigns benefits to 1 organization
I20230127002866 FL Practitioner - Emergency Medicine 6305071770 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Health Trust of Miami Dade County FloridaGroup PAC ID 1759432362, 132 clinicians

Practice addresses (Care Compare)

1611 NW 12 Ave
Miami, FL 33136-1005
Phone (305) 585-7110

Hospital & facility affiliations

  • Jackson Health System Hospital, Miami, FL, CCN 100022

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
121092CAMDMental Health Counselor
A121092CAMDEmergency Medicine Physician
2883733NYMDEmergency Medicine Physician
53074TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida Emergency Medicine CurrentSince Jan 17, 2023 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients

Locations

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

100 Nicolls Rd
#7400L4
Stony Brook, NY 11794

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: rvalenzuela1696454@nychhc.direct-ci.com
  • Direct secure messaging: rolando.valenzuela@direct.stonybrookmedicine.edu

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1275794885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 SW 15TH RD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331291011",
            "telephone_number": "917-439-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HSC LEVEL 4 RM 080",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-2478",
            "fax_number": "323-226-6465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave Dept Of",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361096",
            "country_code": "US",
            "telephone_number": "917-439-1662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "ROLANDO",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A121092",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "2883733",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "53074",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME160487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.