Individual provider Active NPI

Isabel C. Valencia, MD

  • Dermatology Physician
  • Tampa, FL
National Provider Identifier
1700816162
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME90217 Issued in FL
Practice address
11601 Sheldon Rd
Tampa, FL 33626-4306
Phone
(813) 324-6630
Fax
(813) 926-1500
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X ME90217 FL
Dermatology Physician 207N00000X ME90217 FL Primary

Addresses

Primary practice location

11601 Sheldon Rd
Tampa, FL 33626-4306

Mailing address

4919 Memorial Hwy Ste 150
Tampa, FL 33634-7516
Phone (813) 333-1512

Other identifiers 1

IdentifierTypeStateIssuer
110484700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ivalencia@dmp.emadirect.md Direct

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
I20060728000352 FL Practitioner - Dermatology 4688697857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palm Harbor Dermatology PAGroup PAC ID 4789758558, 33 clinicians

Practice addresses (Care Compare)

11601 Sheldon Rd
Tampa, FL 33626-4306
Phone (813) 324-6630

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision31
Removal of skin lesions921
Skin biopsy323

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME90217FLMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Harbor Dermatology PA Dermatology CurrentSince Jan 1, 2014 Accepting new patients
Garden State Bariatrics & Wellness Center,LLC Past Accepting new patients

Locations

4197 Woodlands Pkwy
Fl 2
Palm Harbor, FL 34685
Phone (727) 786-3810

4197 Woodlands Pkwy
Palm Harbor, FL 34685
Phone (727) 786-3810

11601 Sheldon Rd
Tampa, FL 33626
Phone (813) 324-6630

4919 Memorial Hwy
Ste 150
Tampa, FL 33634

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: ivalencia@dmp.emadirect.md

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1700816162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 MEMORIAL HWY STE 150",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336347516",
            "telephone_number": "813-333-1512",
            "fax_number": "813-333-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264306",
            "telephone_number": "813-324-6630",
            "fax_number": "813-926-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "ISABEL",
        "middle_name": "C.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "FL",
            "license": "ME90217",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME90217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110484700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ivalencia@dmp.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11601 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336264306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.