Individual provider Active NPI

Humberto Valdes Jr., M.D., P.A.

  • Specialist
  • Exeter, NH
National Provider Identifier
1316972268
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
6284 Issued in NH
Practice address
196 Water St
Suite 15
Exeter, NH 03833-2422
Phone
(603) 778-1721
Fax
(603) 778-1721
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 6284 NH Primary

Addresses

Primary practice location

196 Water St
Suite 15
Exeter, NH 03833-2422

Mailing address

196 Water St
Suite 15
Exeter, NH 03833-2422
Phone (603) 778-1721

Other identifiers 1

IdentifierTypeStateIssuer
VALD1260074OtherNHNH PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101007000039 NH Practitioner - Psychiatry 3678765815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Miami, LM Miller School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

196 Water St
Exeter, NH 03833-2422
Phone (603) 778-1721

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6284NHMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Humberto Valdes Jr MD PA CurrentSince Sep 28, 2015 Accepting new patients

Locations

196 Water St
Ste 15
Exeter, NH 03833
Phone (603) 778-1721

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1316972268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 WATER ST",
            "address_2": "SUITE 15",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332422",
            "telephone_number": "603-778-1721",
            "fax_number": "603-778-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 WATER ST",
            "address_2": "SUITE 15",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332422",
            "telephone_number": "603-778-1721",
            "fax_number": "603-778-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "HUMBERTO",
        "name_suffix": "Jr.",
        "credential": "M.D., P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NH",
            "license": "6284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH PROVIDER NUMBER",
            "identifier": "VALD1260074",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

Verify at the official NPI Registry.