Individual provider Active NPI

Ramon Vallarino Jr., MD

  • Specialist
  • Jackson Heights, NY
National Provider Identifier
1417936733
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
205319-2 Issued in NY
Practice address
3704 91St St
Suite E
Jackson Heights, NY 11372-7914
Phone
(718) 396-1742
Fax
(718) 396-3297
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 205319-2 NY Primary

Addresses

Primary practice location

3704 91St St
Suite E
Jackson Heights, NY 11372-7914

Mailing address

3704 91St St
Suite E
Jackson Heights, NY 11372-7914
Phone (718) 396-1742

Other identifiers 1

IdentifierTypeStateIssuer
01756041MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051024000525 NY Practitioner - Physical Medicine and Rehabilitation 3072539527

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
205319-2NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ramon Vallarino, M.D., P.C. Past Accepting new patients
Ramon Vallarino MD PC Past Accepting new patients
Ramon Vallarino Jr, MDPC 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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1417936733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3704 91ST ST",
            "address_2": "SUITE E",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727914",
            "telephone_number": "718-396-1742",
            "fax_number": "718-396-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3704 91ST ST",
            "address_2": "SUITE E",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727914",
            "telephone_number": "718-396-1742",
            "fax_number": "718-396-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLARINO",
        "first_name": "RAMON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "205319-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01756041",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.