Individual provider Active NPI

Alejandro David Vando Pedrosa, MD

  • Family Medicine Physician
  • Jetmore, KS
National Provider Identifier
1295212645
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0447834 Issued in KS
Practice address
810 W Bramley St
Jetmore, KS 67854-9320
Phone
(772) 530-1346
NPI assigned
Jul 27, 2018
Last updated
Jul 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0447834 KS Primary

Addresses

Primary practice location

810 W Bramley St
Jetmore, KS 67854-9320

Mailing address

PO Box 155
Jetmore, KS 67854-0155
Phone (772) 530-1346

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
I20240802002028 FL Practitioner - Family Practice 6901269075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ponce School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

151 E Redstone Ave
Crestview, FL 32539-5352
Phone (850) 689-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0447834KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Dolphin Medical Services LLC Family Medicine CurrentSince Jun 29, 2026 Accepting new patients
Floridian Hospitalist Services, LLC Current Accepting new patients
Floridian Hospitalist Services, LLC CurrentSince Jun 20, 2024 Accepting new patients

Locations

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

250 N Wickham Rd
Melbourne, FL 32935
Phone (321) 637-2600

8491 S US Highway 1
Ste 15
Port St Lucie, FL 34952
Phone (772) 251-9976

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

Interoperability endpoints

  • Direct secure messaging: alejandro.vando@hca4.eclinicaldirectplus.com

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.

Hospital & facility affiliations 5

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": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1295212645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "JETMORE",
            "state": "KS",
            "postal_code": "678540155",
            "telephone_number": "772-530-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W BRAMLEY ST",
            "city": "JETMORE",
            "state": "KS",
            "postal_code": "678549320",
            "telephone_number": "772-530-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDO PEDROSA",
        "first_name": "ALEJANDRO",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-27",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0447834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jetmore, KS

Sources for this page

Verify at the official NPI Registry.