Individual provider Active NPI

Diogenes Ivan Valderrama Torres, M.D.

  • Hospitalist Physician
  • San Antonio, TX
National Provider Identifier
1639447071
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
P9479 Issued in TX
Practice address
4330 Medical Dr
Ste 500
San Antonio, TX 78229-3342
Phone
(210) 576-5306
Fax
(210) 694-0645
NPI assigned
Dec 13, 2011
Last updated
Mar 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 004082 NY
Hospitalist Physician 208M00000X 004082 NY
Hospitalist Physician 208M00000X P9479 TX Primary

Addresses

Primary practice location

4330 Medical Dr
Ste 500
San Antonio, TX 78229-3342

Mailing address

4330 Medical Dr
Ste 500
San Antonio, TX 78229-3342
Phone (210) 576-5306

Other identifiers 2

IdentifierTypeStateIssuer
03470835MedicaidNY
355211YMVUOtherTXWNI PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140729002294 TX Practitioner - Internal Medicine 4486801735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Networks, Inc.Group PAC ID 6002091261, 116 clinicians

Practice addresses (Care Compare)

4330 Medical Dr
Suite 500
San Antonio, TX 78229-3318
Phone (210) 558-0122

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004082NYMDInternal Medicine Physician
P9479TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Networks, Inc. CurrentSince Mar 28, 2016 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

2827 Babcock Rd
San Antonio, TX 78229
Phone (210) 253-9955

4330 Medical Dr
Ste 500
San Antonio, TX 78229
Phone (210) 558-0122

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Interoperability endpoints

  • Direct secure messaging: diogenes.valderrama@wellmed.eclinicaldirectplus.com

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, 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": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1639447071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 MEDICAL DR",
            "address_2": "STE 500",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293342",
            "telephone_number": "210-576-5306",
            "fax_number": "210-694-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 MEDICAL DR",
            "address_2": "STE 500",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293342",
            "telephone_number": "210-576-5306",
            "fax_number": "210-694-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDERRAMA TORRES",
        "first_name": "DIOGENES",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-13",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "004082",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "004082",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "P9479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03470835",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WNI PTAN",
            "identifier": "355211YMVU",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.