Marvin Vallejo, is a medicare enrolled "Oral & Maxillofacial Surgery" provider in Rochester, Minnesota. His current practice location is
200 1st St Sw, Rochester, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(507) 284-2511.
Marvin Vallejo is licensed to practice in Minnesota (license number 68180) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1083078554.
Healthcare Provider's Profile
Full Name | Marvin Vallejo |
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Gender | Male |
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Speciality | Oral & Maxillofacial Surgery |
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Location | 200 1st St Sw, Rochester, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1083078554
- Provider Enumeration Date: 04/11/2016
- Last Update Date: 03/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 9739471244
- Enrollment ID: I20160701000445
Medical Identifiers
Medical identifiers for Marvin Vallejo such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1083078554 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | D13719 (Minnesota) | Secondary |
204E00000X | Oral & Maxillofacial Surgery | 29838 (Minnesota) | Secondary |
204E00000X | Oral & Maxillofacial Surgery | 68180 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Marvin Vallejo is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Marvin Vallejo, 200 1st St Sw, Rochester, MN 55905-0001 Ph: (507) 284-2511 | Marvin Vallejo, 200 1st St Sw, Rochester, MN 55905-0001 Ph: (507) 284-2511 |
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