Individual provider Active NPI

Jeralyn Ellice Brossfield, MD

  • Gynecology Physician
  • Rancho Mirage, CA
National Provider Identifier
1073689683
Registry record updated Jul 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
A064527 Issued in CA
Practice address
72301 Country Club Dr Ste 104
Rancho Mirage, CA 92270-8007
Phone
(760) 573-2761
Fax
(760) 797-7189
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X A064527 CA Primary

Addresses

Primary practice location

72301 Country Club Dr Ste 104
Rancho Mirage, CA 92270-8007

Mailing address

8 Waterloo CT
Rancho Mirage, CA 92270-1663
Phone (760) 567-8208

Other practice location 1

5550 Painted Mirage Rd Ste 215
Las Vegas, NV 89149-4581
Phone (760) 567-8207

Other names 1

  • Jeralyn Ellice Whitehouse Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL info@xohealth.net Health Information Exchange (HIE)

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
I20191206002032 CA Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 0345298659

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A064527CAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jeralyn Brossfield M.D., a Professional Corporation Gynecology Current Accepting new patients
My Optimal Life Gynecology PastSince Oct 25, 2020 Accepting new patients
Eisenhower Medical Center Past Accepting new patients
Neuro Pulse Solutions PastSince Oct 25, 2020 Accepting new patients

Locations

72301 Country Club Dr
Ste 105
Rancho Mirage, CA 92270
Phone (760) 541-6163

Interoperability endpoints

  • Direct secure messaging: jeralyn.brossfield@68785807163396.direct.elationemr.com
  • Direct secure messaging: jeralyn.brossfield@402023130595332.direct.elationemr.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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783728000000",
    "number": "1073689683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WATERLOO CT",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922701663",
            "telephone_number": "760-567-8208",
            "fax_number": "760-797-7189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72301 COUNTRY CLUB DR STE 104",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922708007",
            "telephone_number": "760-573-2761",
            "fax_number": "760-797-7189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5550 Painted Mirage Rd Ste 215",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494581",
            "country_code": "US",
            "telephone_number": "760-567-8207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROSSFIELD",
        "first_name": "JERALYN",
        "middle_name": "ELLICE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2026-07-11",
        "certification_date": "2026-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "A064527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@xohealth.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "72301 Country Club Dr Ste 104",
            "city": "Rancho Mirage",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922708007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JERALYN",
            "last_name": "WHITEHOUSE",
            "middle_name": "ELLICE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rancho Mirage, CA

Sources for this page

Verify at the official NPI Registry.