Individual provider Active NPI

Judith Valencia, MD

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1649478389
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME98844 Issued in FL
Practice address
9804 SW 40TH St
Miami, FL 33165-3912
Phone
(305) 222-9154
Fax
(305) 222-9155
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME98844 FL
General Practice Physician 208D00000X ME98844 FL Primary

Addresses

Primary practice location

9804 SW 40TH St
Miami, FL 33165-3912

Mailing address

4001 SW 4TH St
Coral Gables, FL 33134-1740
Phone (305) 903-7142

Other identifiers 2

IdentifierTypeStateIssuer
279199400MedicaidFL
ME98844OtherFLMEDICAL DOCTOR

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
I20071211000406 FL Practitioner - General PracticePractitioner - Family PracticePractitioner - Pediatric Medicine 2860581022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Family Practice, Pediatric Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9804 SW 40 St
Miami, FL 33165-3912
Phone (305) 222-9154

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Judith Valencia MD PA Pediatrics CurrentSince Jan 24, 2009 Accepting new patients
Valencia Medical Center, Inc CurrentSince May 25, 2022 Accepting new patients
Inti Fernandez MD PA Pediatrics Current Accepting new patients

Locations

9804 SW 40th St
Miami, FL 33165
Phone (305) 222-9154

17366 S Dixie Hwy
Palmetto Bay, FL 33157
Phone (305) 222-9154

Organizations & group practices 3

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1649478389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 SW 4TH ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331341740",
            "telephone_number": "305-903-7142",
            "fax_number": "305-222-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9804 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653912",
            "telephone_number": "305-222-9154",
            "fax_number": "305-222-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME98844",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME98844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279199400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL DOCTOR",
            "identifier": "ME98844",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.