Individual provider Active NPI

Gerson Antonio Valencia Villeda, M.D.

  • Pediatric Cardiology Physician
  • Orlando, FL
National Provider Identifier
1518212612
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
ME142063 Issued in FL
Practice address
1222 S Orange Ave
Orlando, FL 32806-1215
Phone
(407) 649-6907
Fax
(407) 481-2035
NPI assigned
Jul 16, 2012
Last updated
Oct 10, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 271013 NY
Pediatric Cardiology Physician 2080P0202X ME142063 FL Primary

Addresses

Primary practice location

1222 S Orange Ave
Orlando, FL 32806-1215

Mailing address

1222 S Orange Ave
Orlando, FL 32806-1215
Phone (407) 649-6907

Other identifiers 1

IdentifierTypeStateIssuer
103890500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190905000962 FL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 1254604275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

1222 S Orange Ave
Orlando, FL 32806-1215
Phone (407) 650-1300

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
271013NYMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Sep 1, 2019 Accepting new patients
Orlando Health Medical Group Inc Pediatric Cardiology CurrentSince Sep 1, 2019 Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

550 16th St
Fl 5
San Francisco, CA 94158
Phone (415) 476-5153

2290 W Eau Gallie Blvd
Ste 205A
Melbourne, FL 32935
Phone (321) 255-2665

1222 S Orange Ave
Orlando, FL 32806
Phone (407) 649-6907

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

Interoperability endpoints

  • Direct secure messaging: gvalenciavilleda128865@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1518212612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "407-649-6907",
            "fax_number": "407-481-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S ORANGE AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061215",
            "telephone_number": "407-649-6907",
            "fax_number": "407-481-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA VILLEDA",
        "first_name": "GERSON",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NY",
            "license": "271013",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "FL",
            "license": "ME142063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103890500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.