Individual provider Active NPI

Manuel C Vallejo Jr., MD,DMD

  • Anesthesiology Physician
  • Morgantown, WV
National Provider Identifier
1932175528
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25529 Issued in WV
Practice address
1322 Pineview Dr
Morgantown, WV 26505-0710
Phone
(304) 598-3100
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X DS025489L PA
Anesthesiology Physician 207L00000X MD058203L PA
Anesthesiology Physician 207L00000X 25529 WV Primary

Addresses

Primary practice location

1322 Pineview Dr
Morgantown, WV 26505-0710

Mailing address

1322 Pineview Dr
Morgantown, WV 26505-0710
Phone (304) 598-3100

Other practice location 1

930 Chestnut Ridge Rd
Morgantown, WV 26505-2807
Phone (304) 293-2411

Other identifiers 1

IdentifierTypeStateIssuer
001600607MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131118000833 WV Practitioner - Anesthesiology 8022200781 Reassigns benefits to 1 organization
I20250318003365 FL Practitioner - Anesthesiology 8022200781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
West Virginia University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

653 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1680

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (940) 244-4218

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DS025489LPAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia University Medical Corporation CurrentSince Sep 1, 2013 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Anesthesiology Current Accepting new patients
West Virginia University Medical Corporation Anesthesiology CurrentSince Sep 1, 2013 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Mar 13, 2025 Accepting new patients
University of Florida Jacksonville Physicians Inc Anesthesiology CurrentSince Mar 13, 2025 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

1322 Pineview Dr
Morgantown, WV 26505
Phone (304) 598-3100

930 Chestnut Ridge Rd
Morgantown, WV 26505
Phone (304) 293-5299

Interoperability endpoints

  • Direct secure messaging: mvallejo790009@direct.shands.ufl.edu

Organizations & group practices 5

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 2

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1932175528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 PINEVIEW DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265050710",
            "telephone_number": "304-598-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 PINEVIEW DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265050710",
            "telephone_number": "304-598-3100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 Chestnut Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265052807",
            "country_code": "US",
            "telephone_number": "304-293-2411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "MANUEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD,DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "DS025489L",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD058203L",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WV",
            "license": "25529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001600607",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.