Marvin Vallejo, in Rochester, MN - Medicare Oral & Maxillofacial Surgery Provider

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.

Contact Information

	Marvin Vallejo,
	200 1st St Sw, Rochester, MN 55905-0001
	(507) 284-2511
	Not Available

Healthcare Provider's Profile

Full Name	Marvin Vallejo
Gender	Male
Speciality	Oral & Maxillofacial Surgery
Location	200 1st St Sw, Rochester, Minnesota
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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Marvin Vallejo, - Medicare in Rochester, MN