Individual provider Active NPI

Nelson Valenzuela

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1316490675
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340890-1 Issued in NY
Practice address
4215 3Rd Ave FL 2
Bronx, NY 10457-4501
Phone
(718) 294-5891
Fax
(718) 294-2468
NPI assigned
Aug 3, 2016
Last updated
Jun 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F340890-1 NY Primary

Addresses

Primary practice location

4215 3Rd Ave FL 2
Bronx, NY 10457-4501

Mailing address

60 Madison Ave
5TH Floor
New York, NY 10010-1600
Phone (212) 545-2400

Other identifiers 1

IdentifierTypeStateIssuer
04532298MedicaidNY

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20161031002355 NY Practitioner - Nurse Practitioner 8123306883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Healthcare Network IncGroup PAC ID 7416855143, 83 clinicians

Practice addresses (Care Compare)

511 W 157TH St
New York, NY 10032-7601
Phone (212) 781-7979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F340890-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Healthcare Network Inc Current Accepting new patients
Community Healthcare Network, Inc. CurrentSince Mar 16, 2024 Accepting new patients

Locations

1002 Westchester Ave
Bronx, NY 10459
Phone (718) 320-4466

4215 3rd Ave
#2
Bronx, NY 10457
Phone (718) 294-5891

1167 Nostrand Ave
Brooklyn, NY 11225
Phone (718) 778-0198

2581 Atlantic Ave
Brooklyn, NY 11207
Phone (718) 495-6700

999 Blake Ave
Brooklyn, NY 11208
Phone (718) 277-8303

8944 164th St
Jamaica, NY 11432
Phone (718) 523-2123

9704 Sutphin Blvd
Jamaica, NY 11435
Phone (718) 657-7088

3611 21st St
Long Island City, NY 11106
Phone (718) 482-7488

255 E Houston St
New York, NY 10002
Phone (212) 477-1120

44 W 28th St
Fl 5
New York, NY 10001
Phone (212) 545-2439

504 W 158th St
Rm 511
New York, NY 10032

511 W 157th St
New York, NY 10032
Phone (212) 781-7979

60 Madison Ave
Fl 5
New York, NY 10010
Phone (212) 545-2400

81 W 115th St
New York, NY 10026
Phone (212) 426-0088

Networks

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

Interoperability endpoints

  • Direct secure messaging: nelson.valenzuela@chn.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1316490675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MADISON AVE",
            "address_2": "5TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100101600",
            "telephone_number": "212-545-2400",
            "fax_number": "646-312-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 3RD AVE FL 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104574501",
            "telephone_number": "718-294-5891",
            "fax_number": "718-294-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "NELSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-03",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340890-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04532298",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.