Individual provider Active NPI

Elvia Elena Vallejo, M.D.

  • Obstetrics & Gynecology Physician
  • St Petersburg, FL
National Provider Identifier
1215914346
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME104061 Issued in FL
Practice address
700 6TH St S FL 2
St Petersburg, FL 33701-4815
Phone
(727) 893-6198
Fax
(727) 893-6978
NPI assigned
Dec 29, 2005
Last updated
Jan 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME104061 FL Primary

Addresses

Primary practice location

700 6TH St S FL 2
St Petersburg, FL 33701-4815

Mailing address

700 6TH St S FL 2
St Petersburg, FL 33701-4815
Phone (727) 893-6198

Other identifiers 1

IdentifierTypeStateIssuer
001388700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ElviaE.Vallejo@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090826000669 FL Practitioner - Obstetrics/GynecologyPractitioner - Orthopedic Surgery 0749276905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

700 6TH St S
FL 2
St Petersburg, FL 33701-4815
Phone (727) 893-6198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Ohi West Medical Group, LLC CurrentSince Dec 5, 2022 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Dec 5, 2022 Accepting new patients

Locations

1414 Kuhl Ave
#38
Orlando, FL 32806
Phone (407) 481-7179

700 6th St S
Fl 2
St Petersburg, FL 33701
Phone (727) 893-6198

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: elviae.vallejo@direct.mybaycare.org
  • Direct secure messaging: evallejo396807@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1215914346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 6TH ST S FL 2",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014815",
            "telephone_number": "727-893-6198",
            "fax_number": "727-893-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 6TH ST S FL 2",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014815",
            "telephone_number": "727-893-6198",
            "fax_number": "727-893-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "ELVIA",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME104061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001388700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ElviaE.Vallejo@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew St Fl 2",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337593012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.