Individual provider Active NPI

Valery A. Niedermeyer, M.D.

  • Pediatrics Physician
  • Vero Beach, FL
National Provider Identifier
1598799538
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME77490 Issued in FL
Practice address
4675 28TH CT
Vero Beach, FL 32967-1329
Phone
(772) 257-8224
Fax
(772) 213-3157
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X K3930 TX
Pediatrics Physician 208000000X K3930 TX
Pediatrics Physician 208000000X ME77490 FL Primary

Addresses

Primary practice location

4675 28TH CT
Vero Beach, FL 32967-1329

Mailing address

1545 9TH St SW
Vero Beach, FL 32962-4312
Phone (772) 257-8224

Other practice location 1

12196 County Road 512
Fellsmere, FL 32948-5463
Phone (772) 257-8224

Other identifiers 1

IdentifierTypeStateIssuer
ME77490OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K3930TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bond Urgent Care LLC Past Accepting new patients
Acs Primary Care Physicians Southwest, PA Emergency Medicine Past Accepting new patients

Organizations & group practices 2

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1598799538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 9TH ST SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329624312",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4675 28TH CT",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329671329",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12196 County Road 512",
            "address_purpose": "LOCATION",
            "city": "Fellsmere",
            "state": "FL",
            "postal_code": "329485463",
            "country_code": "US",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEDERMEYER",
        "first_name": "VALERY",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K3930",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K3930",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME77490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME77490",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.