Individual provider Active NPI

Maria E Vallejo-Agredano, M.D.

  • Family Medicine Physician
  • Salinas, CA
National Provider Identifier
1619107562
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A104312 Issued in CA
Practice address
559 E Alisal St
Suite 201
Salinas, CA 93905-2516
Phone
(831) 769-8800
Fax
(831) 422-9312
NPI assigned
Jul 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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 A104312 CA Primary

Addresses

Primary practice location

559 E Alisal St
Suite 201
Salinas, CA 93905-2516

Mailing address

1615 Bunker Hill Way
Suite 100
Salinas, CA 93906-6013
Phone (831) 796-1304

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ15685ZOtherCAMEDCARE 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
I20091119000042 CA Practitioner - Family Practice 9335287978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of MontereyGroup PAC ID 2466345632, 186 clinicians

Practice addresses (Care Compare)

559 E Alisal St
Suite 201
Salinas, CA 93905-2516
Phone (831) 769-8800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104312CAMDGeneral Practice Dentistry
A104312CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Monterey Current Accepting new patients
County of Monterey Family Medicine CurrentSince Sep 23, 2009 Accepting new patients
Monterey County Behavioral Health Division Past Accepting new patients
County of Monterey Past Accepting new patients

Locations

1441 Constitution Blvd
Bldg 151
Salinas, CA 93906
Phone (831) 755-8640

559 E Alisal St
Ste 201
Salinas, CA 93905
Phone (831) 769-8800

Interoperability endpoints

  • Direct secure messaging: mvallejoagredano11656@direct.ochin.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1619107562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 BUNKER HILL WAY",
            "address_2": "SUITE 100",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939066013",
            "telephone_number": "831-796-1304",
            "fax_number": "831-757-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 E ALISAL ST",
            "address_2": "SUITE 201",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939052516",
            "telephone_number": "831-769-8800",
            "fax_number": "831-422-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEJO-AGREDANO",
        "first_name": "MARIA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A104312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCARE GROUP",
            "identifier": "ZZZ15685Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

Verify at the official NPI Registry.