Individual provider Active NPI

Tomas C Valdez Jr., DPM

  • Podiatrist
  • Daly City, CA
National Provider Identifier
1811092687
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3922 Issued in CA
Practice address
1850 Sullivan Ave
Ste 310
Daly City, CA 94015
Phone
(650) 296-1906
Fax
(650) 755-3883
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3922 CA Primary

Addresses

Primary practice location

1850 Sullivan Ave
Ste 310
Daly City, CA 94015

Mailing address

1850 Sullivan Ave
Ste No 310
Daly City, CA 94015-2221
Phone (650) 296-1906

Other identifiers 3

IdentifierTypeStateIssuer
3577370001OtherCIGNA ONE
000E39220MedicaidCA
000E39220OtherBLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050817000557 CA Practitioner - Podiatry 4587694765 Practice locations: Daly City, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1850 Sullivan Ave
Daly City, CA 94015-2204
Phone (650) 296-1906

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue246
Removal of nail tissue2135
Removal or shaving of skin growth1858

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3922CAMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1811092687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "STE NO 310",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152221",
            "telephone_number": "650-296-1906",
            "fax_number": "650-755-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "STE 310",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "94015",
            "telephone_number": "650-296-1906",
            "fax_number": "650-755-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "TOMAS",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA ONE",
            "identifier": "3577370001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E39220",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000E39220",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

Verify at the official NPI Registry.