Active NPI
Mark A Valenti, MD
- Family Medicine Physician
- Redmond, OR
National Provider Identifier
1912945619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD13455
- Practice address
- 211 NW Larch Ave
Redmond, OR 97756-1357 - Phone
- (541) 548-2164
- Fax
- (541) 548-0534
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD13455 | OR | Primary |
Addresses
Primary practice location
211 NW Larch Ave
Redmond, OR 97756-1357
Mailing address
PO Box 1420
Redmond, OR 97756-0400
Phone (541) 548-2164
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 280339 | Medicaid | OR | |
| 11135057 | Other | OR | CAQH ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD13455 | OR | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325462400000",
"number": "1912945619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1420",
"city": "REDMOND",
"state": "OR",
"postal_code": "977560400",
"telephone_number": "541-548-2164",
"fax_number": "541-548-0534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 NW LARCH AVE",
"city": "REDMOND",
"state": "OR",
"postal_code": "977561357",
"telephone_number": "541-548-2164",
"fax_number": "541-548-0534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALENTI",
"first_name": "MARK",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2012-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD13455",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "280339",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH ID",
"identifier": "11135057",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redmond, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.