VINCENT VALENCIA M.D.
NPI 1134359243
Family Medicine in Adel, GA

Active since July 23, 2009PECOS EnrolledAccepts Medicare Assignment
78.41/100
CMS Quality Rating
172 MJ TAYLOR RD, ADEL, GA 31620(229) 896-3424 Get Directions Write a Review

NPPES record last updated: March 8, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Vincent Valencia M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VINCENT VALENCIA M.D. (NPI 1134359243) is an individual family medicine provider in Adel, Georgia, licensed in Georgia (MD68751) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with Tift Regional Medical Center, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1134359243
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameVINCENT VALENCIACredential: M.D.
Location Address172 MJ TAYLOR RDAdel, GA 31620-3497
Mailing Address907 18th St E Ste 400Tifton, GA 31794-3684 · (229) 353-3450 · Fax (229) 353-6060
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateJuly 23, 2009
Last NPPES UpdateMarch 8, 2021
NPPES CertifiedMarch 8, 2021
NPI 1134359243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in GA · MD68751
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
172 MJ TAYLOR RD, Adel, GA 31620

Other Identifiers 1

Medicaid003128666AGA

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Vincent Valencia M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860645611
PECOS Enrollment IDI20130104000089
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
28 services28 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Tift Regional Medical Center

Acute Care Hospitals · Tifton, GA
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110095
Location901 E 18th StreetTifton, GA 31793 · Tift County
Emergency services Birthing friendly

Cook Medical Center A Campus Of Tift Reg Med Ctr

Acute Care Hospitals · Adel, GA
OwnershipProprietary
CMS Certification Number110101
Location260 Mj Taylor RoadAdel, GA 31620 · Cook County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31620 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

78.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality58.68
Promoting Interoperability100
Improvement Activities40
Cost66.15

Referred Medical Equipment & Supplies CMS DME claims 7

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers21 claims81 services$6.66 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers11 claims14 services$1.15 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261
DME-Hospital Beds · category DB000N
2 suppliers32 claims32 services$59.46 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
2 suppliers37 claims37 services$6.68 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
3 suppliers30 claims30 services$84.40 avg. paid by Medicare
Lightweight wheelchair K0003
DME-Wheelchairs · category DD000N
2 suppliers13 claims13 services$43.73 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
172 MJ TAYLOR RD
ADEL, GA 31620
Physician Assistant
172 MJ TAYLOR RD
ADEL, GA 31620
Internal Medicine
172 MJ TAYLOR RD
ADEL, GA 31620
Nurse Practitioner
172 MJ TAYLOR RD
ADEL, GA 31620
Nurse Practitioner (Family)
172 MJ TAYLOR RD
ADEL, GA 31620
Nurse Practitioner (Family)
172 MJ TAYLOR RD
ADEL, GA 31620
Nurse Practitioner
172 MJ TAYLOR RD
ADEL, GA 31620
Nurse Practitioner (Family)
172 MJ TAYLOR RD
ADEL, GA 31620

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vincent Valencia's NPI number?

The NPI number for Vincent Valencia is 1134359243. It was assigned to this individual provider in the NPPES registry on July 23, 2009.

Where is Vincent Valencia located?

Vincent Valencia practices at 172 Mj Taylor Rd, Adel, GA 31620. The listed phone number is (229) 896-3424.

What is Vincent Valencia's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Vincent Valencia enrolled in Medicare?

Yes. Vincent Valencia is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Vincent Valencia accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Vincent Valencia as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Vincent Valencia affiliated with any hospitals?

According to CMS data, Vincent Valencia is affiliated with Tift Regional Medical Center and Cook Medical Center A Campus Of Tift Reg Med Ctr.

When was this NPI record last updated?

The NPPES record for Vincent Valencia was last updated on March 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.