Organization Active NPI

Dr. Ramon Valderrama M.D., PC

  • Specialist
  • New York, NY
National Provider Identifier
1639455355
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
144213 Issued in NY
Legal business name
DR. RAMON VALDERRAMA M.D., PC
Practice address
30 E 60TH St
Suite 901
New York, NY 10022-1008
Phone
(212) 319-1929
Fax
(212) 223-3176
NPI assigned
Oct 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Authorized official

Name
Dr. Ramon Valderrama, M.D.NPI 1922104215
Title
President
Phone
(212) 319-1929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 144213 NY Primary

Addresses

Primary practice location

30 E 60TH St
Suite 901
New York, NY 10022-1008

Mailing address

30 E 60TH St
Suite 901
New York, NY 10022-1008
Phone (212) 319-1929

Other identifiers 2

IdentifierTypeStateIssuer
00626384MedicaidNY
144213OtherNYNY STATE LIC NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111103000790 NY Part B Supplier - Clinic/Group Practice 1052584265 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

30 E 60th St
Ste 901
New York, NY 10022
Phone (212) 319-1929

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1639455355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 60TH ST",
            "address_2": "SUITE 901",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221008",
            "telephone_number": "212-319-1929",
            "fax_number": "212-223-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 60TH ST",
            "address_2": "SUITE 901",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100221008",
            "telephone_number": "212-319-1929",
            "fax_number": "212-223-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RAMON VALDERRAMA M.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "VALDERRAMA",
        "authorized_official_first_name": "RAMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-319-1929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "144213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00626384",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LIC NUMBER",
            "identifier": "144213",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.