Brooke Vezino, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A100856 Issued in CA

Practice address

6800 Palm Ave Ste C
Sebastopol, CA 95472-4269

Phone

(707) 824-9999

Fax

(707) 869-5983

NPI assigned

Jul 13, 2007

Last updated

Jun 25, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: brooke.vezino@wchealth.eclinicaldirectplus.com

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.

• SRM Alliance Hospital Services

  dba Petaluma Valley Hospital

  • Skilled Nursing Facility
  • Petaluma, CA
  • NPI 1770703886
  NPD (past)
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  NPD (past)
• West County Health Centers, Inc.

  dba Occidental Area Health Center

  • Federally Qualified Health Center (FQHC)
  • Occidental, CA
  • NPI 1598768962
  NPD (past)

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1477752988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "GUERNEVILLE",
            "state": "CA",
            "postal_code": "954461449",
            "telephone_number": "707-869-5977",
            "fax_number": "707-869-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 PALM AVE STE C",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724269",
            "telephone_number": "707-824-9999",
            "fax_number": "707-869-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEZINO",
        "first_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A100856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538334065",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shiela May Vanderveer, LM, CPM
• Anita Vasudevan, MD
• Aine Therese Vejby, M.S., CCC-SLP
• Lindsay Elizabeth Vermillion
• Jami Lea Vess
• Miranda Viorst, LPCC
• Maria Vodovoz, PHARMD
• Nataliya Vorobets, DDS
• Carina Z. Wagner, L.AC
• David Bernarr Walker, LAC.

• Family Medicine Physician in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.