Jamielou Custodio Breckenridge, MD
NPI 1679010896ActiveIndividual· Surgery· Fort Belvoir, VA
Surgery (MD) in Fort Belvoir, Virginia, trained at Uniformed Services Uhs Fe Hebert School of Med (class of 2017). Mostly services rather than prescriptions: Medicare paid $8,165 for 53 patients in 2024, with only 16 Part D claims. Tela Bio, Inc. reported $31.18 in payments in 2024, mostly food and beverage.
Overview
| NPI | 1679010896 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | Jan 25, 2017 |
| Last updated in NPPES | Sep 6, 2024 |
| Certified by provider | Sep 6, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | 0101276676 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - General Surgery (VA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 53 |
|---|---|
| Services billed | 76 across 16 procedure codes |
| Paid by Medicare | $8,165 |
Part D prescriptions in 2024
| Prescriptions (claims) | 16 · 25 30-day fills |
|---|---|
| Total drug cost | $5,322 |
| Generic share | 75% of claims |
Education and affiliations
| Medical school | Uniformed Services Uhs Fe Hebert School of Med |
|---|---|
| Graduation year | 2017 |
| Medicare specialty | General Surgery |
Medical group
- Valley Physician Enterprise IncWinchester, VA · 135 clinicians
Hospital affiliation
- Winchester Medical CenterWinchester, VA
Industry payments (Open Payments)
- 2024$31.18 · 1 payment from 1 company
Top paying companies in 2024
| Company | Amount | Payments |
|---|---|---|
| Tela Bio, Inc. | $31.18 | 1 |
What the 2024 payments were for
- Food and Beverage$31.18 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 15 general surgeons in Fort Belvoir · All general surgeons in Virginia