Conrado A Valdes, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD037357L Issued in PA

Practice address

763 Johnsonburg Rd
Erpg Anesthesia Services
St Marys, PA 15857-3417

Phone

(814) 788-8189

Fax

(814) 788-8387

NPI assigned

Aug 10, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730180951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 JOHNSONBURG RD",
            "address_2": "ERPG ANESTHESIA SERVICES",
            "city": "ST MARYS",
            "state": "PA",
            "postal_code": "158573417",
            "telephone_number": "814-788-8189",
            "fax_number": "814-788-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 JOHNSONBURG RD",
            "address_2": "ERPG ANESTHESIA SERVICES",
            "city": "ST MARYS",
            "state": "PA",
            "postal_code": "158573417",
            "telephone_number": "814-788-8189",
            "fax_number": "814-788-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "CONRADO",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD037357L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018557990001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008473230005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in St Marys, PA
• Providers in St Marys, PA by specialty
• Anesthesiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.