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YESENIA VALDEZ MD
NPI 1871936146
Family Medicine in Oak Park, IL

Active since April 16, 2013PECOS EnrolledAccepts Medicare Assignment
610 S MAPLE AVE STE 3900, OAK PARK, IL 60304(815) 223-0196 Get Directions Write a Review

NPPES record last updated: May 27, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 27, 2020, Nov 8, 2016 (2 updates tracked since 2016).

About Yesenia Valdez Md NPPES

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

YESENIA VALDEZ MD (NPI 1871936146) is an individual family medicine provider in Oak Park, Illinois, licensed in Illinois (036138946) and active in the NPI registry since April 2013. She is enrolled in Medicare PECOS, is affiliated with Rush Oak Park Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2013).

NPPES Registry Identity

NPI1871936146
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameYESENIA VALDEZCredential: MD
Location Address610 S MAPLE AVE STE 3900Oak Park, IL 60304-1095
Mailing Address610 S Maple Ave Ste 3900Oak Park, IL 60304-1095 · (708) 524-1674
Phone(815) 223-0196
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2013
Enumeration DateApril 16, 2013
Last NPPES UpdateMay 27, 20202 updates tracked since enumeration
NPPES CertifiedMay 27, 2020
✔ NPI 1871936146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036138946
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.
610 S MAPLE AVE STE 3900, Oak Park, IL 60304
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Yesenia Valdez Md 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 ID4981914090
PECOS Enrollment IDI20160113002020
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.

Medicare Billing Reassignments

4

Medicare enrollment records show Yesenia Valdez reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Rush Oak Park Physicians Group Anchor
Same address
Family Medicine
610 S MAPLE AVE, SUITE 3900
Oak Park, IL 60304
  • Reassigned Medicare billing, Illinois enrollment
  • 16 clinicians in this Medicare group
NPI 1396018453 (708) 524-1674
Rush Oak Park ER Physicians Group
0.1 mi
Emergency Medical Services
520 S MAPLE AVE, EMERGENCY DEPARTMENT
Oak Park, IL 60304
  • Reassigned Medicare billing, Illinois enrollment
  • 124 clinicians in this Medicare group
NPI 1447260880 (708) 660-5995
Rush Oak Park Physicians Group Elmwood Park
2.3 mi
Family Medicine
7734 W NORTH AVE
Elmwood Park, IL 60707
  • Reassigned Medicare billing, Illinois enrollment
  • 9 clinicians in this Medicare group
NPI 1326318627 (708) 456-6611
Rush University Medical Center
6.7 mi
Internal Medicine
2011 YORK ROAD, 2ND FLOOR
Oak Brook, IL 60523
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Rush University Medical Group
  • 2,169 clinicians in this Medicare group
NPI 1801375696 (630) 724-1310

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

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.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
131 services85 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
63 services63 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
57 services46 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
54 services54 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
32 services29 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
23 services23 patients

Hospital Affiliations CMS Care Compare 2

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

Rush Oak Park Hospital

Acute Care Hospitals · Oak Park, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140063
Location520 S Maple AveOak Park, IL 60304 · Cook County
Emergency services

Rush University Medical Center

Acute Care Hospitals · Chicago, IL
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140119
Location1653 West Congress ParkwayChicago, IL 60612 · Cook County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60304 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
60%118 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
25%198 patients2/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
40%94 patients2/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%4,326 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
85%455 patients4/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
94%246 patients3/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
90%1,094 patients4/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
43%555 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 375 patients
Patients tobacco: 18% · 121 patients
73%375 patients3/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
66%1,094 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
12%1,094 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
22%1,094 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

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
8 suppliers15 claims32 services$6.39 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers11 claims12 services$1.17 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 2

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

DR. SARA M MOUSA DO
Family Medicine
610 S MAPLE AVE STE 3900
OAK PARK, IL 60304
Cook County (708) 524-1674
DR. JOANNE SONSERAY MARTIRES MD
Internal Medicine (Critical Care Medicine)
610 S MAPLE AVE STE 3900
OAK PARK, IL 60304
Cook County (708) 660-2240

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 Yesenia Valdez's NPI number?

The NPI number for Yesenia Valdez is 1871936146. It was assigned to this individual provider in the NPPES registry on April 16, 2013.

Where is Yesenia Valdez located?

Yesenia Valdez practices at 610 S Maple Ave Ste 3900, Oak Park, IL 60304. The listed phone number is (815) 223-0196.

What is Yesenia Valdez's specialty?

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

Is Yesenia Valdez enrolled in Medicare?

Yes. Yesenia Valdez 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.

Which organizations bill Medicare for Yesenia Valdez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Yesenia Valdez reassigns Medicare benefits to 4 organizations: Rush Oak Park Physicians Group Anchor (Oak Park, IL), Rush Oak Park ER Physicians Group (Oak Park, IL), Rush Oak Park Physicians Group Elmwood Park (Elmwood Park, IL) and Rush University Medical Center (Oak Brook, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Yesenia Valdez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Yesenia Valdez accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Home State Health list Yesenia Valdez 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 Yesenia Valdez affiliated with any hospitals?

According to CMS data, Yesenia Valdez is affiliated with Rush Oak Park Hospital and Rush University Medical Center.

When was this NPI record last updated?

The NPPES record for Yesenia Valdez was last updated on May 27, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.