Individual provider Active NPI

Maria D Valicenti-McDermott, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1689794059
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
229358 Issued in NY
Practice address
1225 Morris Park Ave
Bronx, NY 10461-1949
Phone
(718) 839-7284
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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 229358 NY
Developmental - Behavioral Pediatrics Physician 2080P0006X 229358 NY Primary

Addresses

Primary practice location

1225 Morris Park Ave
Bronx, NY 10461-1949

Mailing address

15 Hewitt Ave
White Plains, NY 10605-3905
Phone (914) 761-0960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080422000644 NY Practitioner - Pediatric Medicine 0547348187 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229358NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jul 16, 2016 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince Jul 16, 2016 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1410 Pelham Pkwy S
Bronx, NY 10461
Phone (718) 430-8500

1225 Morris Park Ave
Bronx, NY 10461
Phone (718) 430-8500

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1689794059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HEWITT AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106053905",
            "telephone_number": "914-761-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MORRIS PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611949",
            "telephone_number": "718-839-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALICENTI-MCDERMOTT",
        "first_name": "MARIA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "229358",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NY",
            "license": "229358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.