Reggie Donald Valdemar, PHMNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

404034 Issued in NY

Practice address

153 Lake Shore Rd
Ronkonkoma, NY 11779-3157

Phone

(111) 111-1111

NPI assigned

Mar 31, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Valdemar NP in Psychiatry PLLC

  • Clinic/Center
  • North Babylon, NY
  • NPI 1225873870
  Medicare reassignment NPD Authorized official
• Phoenix Houses of Long Island, Inc.

  • Substance Abuse Rehabilitation Facility
  • Brentwood, NY
  • NPI 1174691281
  Medicare reassignment NPD

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672012800000",
    "number": "1285374660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 OAK PARK CT",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117295607",
            "telephone_number": "631-565-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 LAKE SHORE RD",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117793157",
            "telephone_number": "111-111-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Oak Park Ct",
            "address_purpose": "LOCATION",
            "city": "Deer Park",
            "state": "NY",
            "postal_code": "117295607",
            "country_code": "US",
            "telephone_number": "631-565-3480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDEMAR",
        "first_name": "REGGIE",
        "middle_name": "DONALD",
        "credential": "PHMNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-12-26",
        "certification_date": "2022-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Tursi
• Megan Tutone
• United Rehab Hands on Physical Therapy, PLLC
• United Rehab Physical Therapy P.C.
• Urgent Chiropractic P.C.
• Victoria Valentin, LMHC
• Marilyn Valle
• Taylor A Vanderhoef
• Christopher Varvaro
• Yojaira B Vasquez

• Psychiatric/Mental Health Nurse Practitioner in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.