Individual provider Active NPI

Mercy Diana Valenzuela, CNM

  • Advanced Practice Midwife
  • Brawley, CA
National Provider Identifier
1992175004
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
235754 Issued in CA
Practice address
751 W Legion Rd
Brawley, CA 92227-7732
Phone
(209) 956-7725
NPI assigned
Oct 1, 2015
Last updated
Dec 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 235754 CA
Women's Health Nurse Practitioner 363LW0102X NP95003076 CA
Advanced Practice Midwife 367A00000X 235754 CA Primary

Addresses

Primary practice location

751 W Legion Rd
Brawley, CA 92227-7732

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190618003059 CA Practitioner - Certified Nurse Midwife (CNM) 0547594954 Reassigns benefits to 1 organization
Practice locations: Brawley, CA; Calexico, CA

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

207 W Legion Rd
Brawley, CA 92227-7780
Phone (760) 351-3333

750 W Legion Rd
Suite 204
Brawley, CA 92227-7731

751 W Legion Rd
Suite 204
Brawley, CA 92227-7755
Phone (760) 351-2626

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
NP95003076CAMDWomen's Health Nurse Practitioner
235754CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneers Memorial Healthcare District CurrentSince Apr 23, 2021 Accepting new patients
Pathology Associates of Southern California Current Accepting new patients

Locations

751 W Legion Rd
Brawley, CA 92227
Phone (760) 351-0025

751 W Legion Rd
Ste 201
Brawley, CA 92227
Phone (760) 351-0025

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

751 W Legion Rd
Ste 204
Brawley, CA 92227
Phone (760) 351-2626

450 E Birch St
Calexico, CA 92231
Phone (760) 768-6262

Dept LA 23624
Pasadena, CA 91185

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/11d6e9da-d3d5-4352-8d64-f06e0d461c57/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1443657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1992175004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 W LEGION RD",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277732",
            "telephone_number": "209-956-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "MERCY",
        "middle_name": "DIANA",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-01",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "235754",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "NP95003076",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, CA

Sources for this page

Verify at the official NPI Registry.