Individual provider Active NPI

Ava Diane Valdez, PAC

  • Physician Assistant
  • Morrison, IL
National Provider Identifier
1376717439
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-001567 Issued in IL
Practice address
635 E Lincolnway
Morrison, IL 61270-2963
Phone
(815) 772-7491
Fax
(815) 772-7891
NPI assigned
Apr 18, 2008
Last updated
Jan 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-001567 IL Primary

Addresses

Primary practice location

635 E Lincolnway
Morrison, IL 61270-2963

Mailing address

915 13TH Ave N
Clinton, IA 52732-5067
Phone (563) 243-2511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20131108001399 IL Practitioner - Physician Assistant 2163657610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

303 N Jackson St
Morrison, IL 61270-3042
Phone (815) 772-4003

635 E Lincolnway
Morrison, IL 61270-2963
Phone (815) 772-7491

657 W Lincolnway
Morrison, IL 61270-2056
Phone (815) 772-5567

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
82.54
Promoting interoperability
89.05
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-001567ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Specialty Clinic CurrentSince Jul 1, 2019 Accepting new patients
Morrison Community Hospital District Current Accepting new patients
Morrison Community Hospital District Physician Assistant CurrentSince May 4, 2024 Accepting new patients
Ortho Rehab Specialists PLLC Past Accepting new patients
CGH Medical Center Past Accepting new patients

Locations

1410 N 4th St
Clinton, IA 52732
Phone (563) 244-5555

915 13th Ave N
Clinton, IA 52732
Phone (319) 243-2511

1705 16th Ave
Fulton, IL 61252
Phone (815) 589-2121

303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003

635 E Lincolnway
Morrison, IL 61270
Phone (815) 772-7274

657 W Lincolnway
Morrison, IL 61270
Phone (815) 772-4003

Interoperability endpoints

  • Direct secure messaging: avavaldez@mchospital.medalliesdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1376717439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325067",
            "telephone_number": "563-243-2511",
            "fax_number": "563-243-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 E LINCOLNWAY",
            "city": "MORRISON",
            "state": "IL",
            "postal_code": "612702963",
            "telephone_number": "815-772-7491",
            "fax_number": "815-772-7891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "AVA",
        "middle_name": "DIANE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morrison, IL

Sources for this page

Verify at the official NPI Registry.