Individual provider Active NPI

Brenda Nelida Pelayo, DO

  • Internal Medicine Physician
  • Fontana, CA
National Provider Identifier
1255911053
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A21280 Issued in CA
Practice address
17234 Valley Blvd
Building a
Fontana, CA 92335-6720
Phone
(909) 427-2608
NPI assigned
Apr 14, 2021
Last updated
Mar 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20A21280 CA Primary

Addresses

Primary practice location

17234 Valley Blvd
Building a
Fontana, CA 92335-6720

Mailing address

17234 Valley Blvd
Building a
Fontana, CA 92335-6720

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20250214002925 CA Practitioner - Internal Medicine 5294123238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

43322 Gingham Ave
Lancaster, CA 93535-4576
Phone (661) 579-9317

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A21280CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bartz-Altadonna Community Health Center CurrentSince Jan 6, 2025 Accepting new patients
Bartz-Altadonna Community Health Center Single Specialty CurrentSince Jan 6, 2025 Accepting new patients

Locations

43210 Gingham Ave
Lancaster, CA 93535
Phone 6618744050222

43322 Gingham Ave
Lancaster, CA 93535
Phone (661) 579-9317

43322 Gingham Ave
Ste 105
Lancaster, CA 93535
Phone 6618744050222

2520 E Palmdale Blvd
Palmdale, CA 93550
Phone (661) 266-8551

2520 E Palmdale Blvd
Ste A
Palmdale, CA 93550

Organizations & group practices 2

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.

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": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1255911053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17234 VALLEY BLVD",
            "address_2": "BUILDING A",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17234 VALLEY BLVD",
            "address_2": "BUILDING A",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720",
            "telephone_number": "909-427-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELAYO",
        "first_name": "BRENDA",
        "middle_name": "NELIDA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A21280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.