Individual provider Active NPI

Victoria C Valdecanas, M.D.

  • Family Medicine Physician
  • Prescott Valley, AZ
National Provider Identifier
1336197938
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23288 Issued in AZ
Practice address
7700 E Florentine Rd Ste 202
Prescott Valley, AZ 86314-2245
Phone
(928) 442-8710
Fax
(928) 442-8742
NPI assigned
May 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23288 AZ Primary

Addresses

Primary practice location

7700 E Florentine Rd Ste 202
Prescott Valley, AZ 86314-2245

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (928) 759-5874

Other identifiers 1

IdentifierTypeStateIssuer
Z110773OtherAZMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23288AZMDOphthalmic Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Tucson Emergency Physicians, PC Past Accepting new patients
Yavapai Regional Medical Center Physician Care LLC Family Medicine Past Accepting new patients
Emergency Room Associates Limited Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1336197938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "928-759-5874",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 E FLORENTINE RD STE 202",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142245",
            "telephone_number": "928-442-8710",
            "fax_number": "928-442-8742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDECANAS",
        "first_name": "VICTORIA",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "23288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z110773",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

Verify at the official NPI Registry.