Individual provider Active NPI

Miel Marie Vallejo-Brooks, MD

  • Obstetrics Physician
  • San Jose, CA
National Provider Identifier
1215952056
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
License
A77518 Issued in CA
Practice address
751 S Bascom Ave
OB/GYN Dept
San Jose, CA 95128-2604
Phone
(408) 885-5550
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics Physician 207VX0000X A77518 CA Primary

Addresses

Primary practice location

751 S Bascom Ave
OB/GYN Dept
San Jose, CA 95128-2604

Mailing address

PO Box 5280
Patient Business Services
San Jose, CA 95150-5280
Phone (408) 885-7200

Other identifiers 1

IdentifierTypeStateIssuer
00A775180MedicaidCA

Other names 1

  • Miel Marie Vallejo Former name

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
I20040712001044 CA Practitioner - Obstetrics/Gynecology 4284612672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of California, Davis School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Santa ClaraGroup PAC ID 1254244973, 1,000 clinicians

Practice addresses (Care Compare)

751 S Bascom Ave
Santa Clara Vly Med
San Jose, CA 95128-2604
Phone (408) 885-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A77518CAMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Santa Clara CurrentSince May 11, 2018 Accepting new patients
County of Santa Clara Current Accepting new patients
County of Santa Clara CurrentSince May 11, 2018 Accepting new patients
County of Santa Clara Past Accepting new patients

Locations

2425 Enborg Ln
San Jose, CA 95128
Phone (408) 885-5400

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

750 S Bascom Ave
#1112
San Jose, CA 95128

500 Tully Rd
San Jose, CA 95111
Phone (408) 817-1433

Interoperability endpoints

  • Direct secure messaging: mvallejobrooks11666@santaclaravalley.direct-ci.net

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.

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1215952056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5280",
            "address_2": "PATIENT BUSINESS SERVICES",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951505280",
            "telephone_number": "408-885-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "OB/GYN DEPT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO-BROOKS",
        "first_name": "MIEL",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": "A77518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A775180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIEL",
            "last_name": "VALLEJO",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.