Jamielou Custodio Breckenridge, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

0101276676 Issued in VA

Practice address

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Phone

(571) 231-3224

NPI assigned

Jan 25, 2017

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

General Surgery

Education

Uniformed Services Uhs Fe Hebert School of Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Physician Enterprise IncGroup PAC ID 9931268091, 176 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Winchester Medical Center Hospital, Winchester, VA, CCN 490005

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbreckenridge1210657@valleyhealth.direct-ci.com

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.

• Valley Physician Enterprise, Inc

  • Surgery Physician
  • Winchester, VA
  • NPI 1538316203
  Medicare reassignment Care Compare group NPD
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  Medicare reassignment NPD
• Winchester Medical Center

  • Critical Care Medicine (Internal Medicine) Physician
  • Winchester, VA
  • NPI 1679711261
  Medicare reassignment NPD
• Shenandoah Valley Pathology Laboratories Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Winchester, VA
  • NPI 1447363114
  NPD
• Valley Physician Enterprise, Inc.

  • Obstetrics & Gynecology Physician
  • Winchester, VA
  • NPI 1255222535
  NPD
• Winchester Medical Center

  • Pediatrics Physician
  • Winchester, VA
  • NPI 1013874742
  NPD
• Winchester Medical Center

  • Obstetrics & Gynecology Physician
  • Winchester, VA
  • NPI 1760433791
  NPD
• Winchester Medical Center

  • Clinical Medical Laboratory
  • Winchester, VA
  • NPI 1790024909
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Winchester Medical Center

  • General Acute Care Hospital
  • Winchester, VA
  • NPI 1619928017
  Care Compare affiliation
• Winchester Medical Center

  • Clinical Medical Laboratory
  • Winchester, VA
  • NPI 1790024909

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1679010896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-3224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 Campus Blvd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012872",
            "country_code": "US",
            "telephone_number": "540-536-0130",
            "fax_number": "540-536-0140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1840 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-536-8000",
            "fax_number": "540-536-7780",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Sentara Cir Ste 202",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231885727",
            "country_code": "US",
            "telephone_number": "757-984-9850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRECKENRIDGE",
        "first_name": "JAMIELOU",
        "middle_name": "CUSTODIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101276676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbreckenridge1210657@ValleyHealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "190 Campus Blvd Ste 310",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbreckenridge1210657@ValleyHealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Nicole Bowman, MD
• Robert Dean Bowman, RN
• Roderick Bowser, PMHNP
• Christine Brady, PSYD
• Benjamin Bray, COTA/L
• Bonnie L. Breneman, RNC/WHNP
• Conchetta Vinson Brevard, RDH
• Jacob C Brezinsky, DDS
• Nancy Dee Briggs, MC
• Laura Josefina Brito, LCSW

• Surgery Physician in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.