Gerard Vallejo, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

L5936 Issued in TX

Practice address

379 FM 2972 W
Rusk, TX 75785-3666

Phone

(903) 683-5781

NPI assigned

Apr 3, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gvallejo344831@christushealth.direct-ci.net

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.

• Tyler Family Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Tyler, TX
  • NPI 1144575820
  Medicare reassignment NPD
• Tyler Family Circle of Care

  • Community/Retail Pharmacy
  • Tyler, TX
  • NPI 1942011903
  NPD

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1285029538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 FM 2972 W",
            "city": "RUSK",
            "state": "TX",
            "postal_code": "757853666",
            "telephone_number": "903-683-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 FM 2972 W",
            "city": "RUSK",
            "state": "TX",
            "postal_code": "757853666",
            "telephone_number": "903-683-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "L5936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakshmi Srinivasan, FNP
• Stacy Black, DDS, PA
• Ma Camille Tabtab, PMHNP-BC
• Cassie Jean Thacker
• Lisa Kathryn Trawick, NP
• Kendra R Verhelle, MD
• Rebecca Ann Vogt, SLP
• Kristina L Waggoner, PMHNP-BC
• West Wharton County Hospital District
• Young Youn, MD

• Psychiatry Physician in Rusk, TX
• Providers in Rusk, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.