Individual provider Active NPI

Javier Valero Fonseca, M.D.

  • Neurology Physician
  • Modesto, CA
National Provider Identifier
1972642239
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
C153203 Issued in CA
Practice address
1524 McHenry Ave Ste 570
Modesto, CA 95350-4574
Phone
(209) 572-3880
Fax
(209) 572-3349
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X C153203 CA
Pediatrics Physician 208000000X 45505 TN
Neurology Physician 2084N0400X 45505 TN
Neurology Physician 2084N0400X C153203 CA Primary

Addresses

Primary practice location

1524 McHenry Ave Ste 570
Modesto, CA 95350-4574

Mailing address

1524 McHenry Ave Ste 570
Modesto, CA 95350-4574
Phone (209) 572-3880

Other names 1

  • Javier Valero Professional name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180306002958 CA Practitioner - Neurology 4183810823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Childrens Medical GroupGroup PAC ID 9032439336, 50 clinicians

Practice addresses (Care Compare)

1524 McHenry Ave
Modesto, CA 95350-4500
Phone (209) 572-3880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45505TNMDPediatrics Physician
C153203CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Children'S Medical Group Pediatrics CurrentSince Mar 19, 2018 Accepting new patients
Murfreesboro Medical Clinic, P.a. Current Accepting new patients
Pediatrix Medical Group of Tennessee, P.C. Pediatrics PastSince Oct 24, 2015 Accepting new patients
Saint Thomas Rutherford Hospital Past Accepting new patients

Locations

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

1190 Olivewood Dr
Ste A
Merced, CA 95348

1524 McHenry Ave
Ste 570
Modesto, CA 95350
Phone (209) 572-3880

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

1272 Garrison Dr
Murfreesboro, TN 37129
Phone (615) 867-7925

Interoperability endpoints

  • Direct secure messaging: jvalerofonseca15885@valleychildrens-prd.direct-ci.com

Organizations & group practices 4

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1972642239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE STE 570",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504574",
            "telephone_number": "209-572-3880",
            "fax_number": "209-572-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE STE 570",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504574",
            "telephone_number": "209-572-3880",
            "fax_number": "209-572-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALERO FONSECA",
        "first_name": "JAVIER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C153203",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "45505",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "45505",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "C153203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAVIER",
            "last_name": "VALERO",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.