NPIMap

Individual provider Active NPI

Brandon A Vannoord, MD

  • Interventional Pain Medicine Physician
  • San Diego, CA
National Provider Identifier
1558407510
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
A113568 Issued in CA
Practice address
3405 Kenyon St Ste 305
San Diego, CA 92110-5007
Phone
(619) 849-5777
Fax
(619) 849-5776
NPI assigned
Jan 29, 2007
Reactivated
Feb 15, 2019
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X A113568 CA
General Practice Physician 208D00000X 23831 NE
Interventional Pain Medicine Physician 208VP0014X A113568 CA Primary

Addresses

Primary practice location

3405 Kenyon St Ste 305
San Diego, CA 92110-5007

Mailing address

3405 Kenyon St Ste 305
San Diego, CA 92110-5007
Phone (619) 849-5777

Other names 1

  • Dr. Brandon Alan Vannoord Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140618000432 CA Practitioner - Interventional Pain ManagementPractitioner - Pain Management 4385868173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Pain Management
Education
University of Southern California Keck School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Relieve Pain Center IncGroup PAC ID 4981943180, 4 clinicians

Practice addresses (Care Compare)

3969 4TH Ave
Suite 208
San Diego, CA 92103-3165
Phone (619) 849-5777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.52 of 100Reported as group
Quality
53.06
Promoting interoperability
88
Improvement activities
40
Cost
68.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23831NEMDGeneral Practice Physician
A113568CAMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Relieve Pain Center, Inc. Pain Medicine CurrentSince Oct 2, 2018 Accepting new patients
Scripps Health Current Accepting new patients
Sharp Memorial Hospital Interventional Pain Medicine Past Accepting new patients
Scripps Health Past Accepting new patients
Scripps Health Interventional Pain Medicine Past Accepting new patients
Scripps Health Interventional Pain Medicine Past Accepting new patients
Scripps Health Interventional Pain Medicine Past Accepting new patients

Locations

3405 Kenyon St
Ste 305
San Diego, CA 92110
Phone (619) 849-5777

3969 4th Ave
Ste 208
San Diego, CA 92103
Phone (619) 294-7300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: brandonvannoord@rpc.allscriptsdirect.net
  • Direct secure messaging: brandonvannoord@rpcinc.allscriptsdirect.net
  • Direct secure messaging: bvannoord61426@scrippshlth.medalliesdirect.net

Organizations & group practices 7

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 4

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1558407510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 KENYON ST STE 305",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105007",
            "telephone_number": "619-849-5777",
            "fax_number": "619-849-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 KENYON ST STE 305",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921105007",
            "telephone_number": "619-849-5777",
            "fax_number": "619-849-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNOORD",
        "first_name": "BRANDON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "deactivation_date": "2019-02-11",
        "reactivation_date": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A113568",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "23831",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A113568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDON",
            "last_name": "VANNOORD",
            "middle_name": "ALAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.