Individual provider Active NPI

Gregg A Valenzuela, M.D.

  • Gastroenterology Physician
  • Richmond, VA
National Provider Identifier
1942250188
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
0101036504 Issued in VA
Practice address
7702 E Parham Rd
Suite 101
Richmond, VA 23294-4371
Phone
(804) 288-7901
Fax
(804) 273-9167
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101036504 VA Primary

Addresses

Primary practice location

7702 E Parham Rd
Suite 101
Richmond, VA 23294-4371

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-6770

Other identifiers 1

IdentifierTypeStateIssuer
5857449MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120712000345 NM Practitioner - Gastroenterology 9032216940 Reassigns benefits to 1 organization
I20250227002035 OK Practitioner - Gastroenterology 9032216940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Virginia School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8005 C Creighton Pkwy
Suite 807
Mechanicsville, VA 23111-4593

PO Box
Kansas City, MO 64180

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy125
Upper gastrointestinal (GI) endoscopy for acid reflux200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101036504VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince May 1, 2023 Accepting new patients
Stillwater Medical Center Authority CurrentSince Jan 1, 2025 Accepting new patients
Southwest Medical Associates, LLC CurrentSince May 1, 2023 Accepting new patients
Stillwater Medical Center Authority Gastroenterology CurrentSince Jan 1, 2025 Accepting new patients
Riverside Physician Services Inc Gastroenterology Past Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

4705 Montgomery Blvd NE
Ste 201
Albuquerque, NM 87109
Phone (505) 727-6550

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1301 W 6th Ave
Ste 108
Stillwater, OK 74074
Phone (405) 533-1695

Interoperability endpoints

  • Direct secure messaging: gregg.valenzuela.p1@direct.smc.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1942250188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 E PARHAM RD",
            "address_2": "SUITE 101",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232944371",
            "telephone_number": "804-288-7901",
            "fax_number": "804-273-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "GREGG",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101036504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5857449",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.