Individual provider Active NPI

Beth L Valmassoi, NP

  • Adult Health Nurse Practitioner
  • Royal Oak, MI
National Provider Identifier
1629131644
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704138683 Issued in MI
Practice address
32121 Woodward Ave Ste 200
Royal Oak, MI 48073-0999
Phone
(248) 690-9946
Fax
(248) 268-3661
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704138683 MI Primary

Addresses

Primary practice location

32121 Woodward Ave Ste 200
Royal Oak, MI 48073-0999

Mailing address

32121 Woodward Ave Ste 200
Royal Oak, MI 48073-0999
Phone (248) 690-9946

Other identifiers 1

IdentifierTypeStateIssuer
4537169MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040226000702 MI Practitioner - Nurse Practitioner 4082500954 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704138683MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Kidney Consultants, P.C. CurrentSince Jul 17, 2003 Accepting new patients

Locations

44200 Woodward Ave
Ste 209
Pontiac, MI 48341
Phone (248) 253-0330

1866 W Auburn Rd 400
Rochester Hills, MI 48309

1886 W Auburn Rd
Ste 400
Rochester Hills, MI 48309
Phone 2482903111 ext. 1713

23077 Greenfield Rd
Ste 161
Southfield, MI 48075
Phone (248) 557-9010

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1629131644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32121 WOODWARD AVE STE 200",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730999",
            "telephone_number": "248-690-9946",
            "fax_number": "248-268-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32121 WOODWARD AVE STE 200",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730999",
            "telephone_number": "248-690-9946",
            "fax_number": "248-268-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALMASSOI",
        "first_name": "BETH",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704138683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4537169",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.