Active NPI
Tito Velasquez
- Physician Assistant
- Fort Lauderdale, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9112704
- Practice address
- 1160 N Federal Hwy Apt 1023
Fort Lauderdale, FL 33304-1436 - Phone
- (312) 833-1183
- NPI assigned
- Oct 31, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9112704 | FL | Primary |
Addresses
Primary practice location
1160 N Federal Hwy Apt 1023
Fort Lauderdale, FL 33304-1436
Mailing address
1160 N Federal Hwy Apt 1023
Fort Lauderdale, FL 33304-1436
Phone (312) 833-1183
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9112704 | Other | FL | NCCPA FLORIDA STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900
3501 Health Ctr Blvd
Estero, FL 34135-8127
9800 S Healthpark Dr
Fort Myers, FL 33908-3630
Hospital & facility affiliations
- Lee Memorial Hospital
- Cape Coral Hospital
- Gulf Coast Medical Center Lee Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9112704 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Memorial Health System | Current | Accepting new patients |
Locations
1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900
3501 Health Center Blvd
Ste 1600
Estero, FL 34135
Phone (239) 343-1219
1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700
9800 S Healthpark Dr
Ste 110
Fort Myers, FL 33908
Phone (239) 344-2307
8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030
16410 Healthpark Commons Dr
Fort Myers, FL 33908
930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520
Networks
- Freedom Health HMO Network
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.
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1942058557
-
- Internal Medicine Physician
- Fort Myers, FL
- NPI 1992873319
-
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
-
- Federally Qualified Health Center (FQHC)
- Port Charlotte, FL
- NPI 1255171765
-
- Federally Qualified Health Center (FQHC)
- Fort Myers, FL
- NPI 1720715295
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1366281750
-
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1427806025
-
- General Acute Care Hospital
- Cape Coral, FL
- NPI 1780429076
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575936000000",
"number": "1013551266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1160 N FEDERAL HWY APT 1023",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333041436",
"telephone_number": "312-833-1183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1160 N FEDERAL HWY APT 1023",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333041436",
"telephone_number": "312-833-1183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELASQUEZ",
"first_name": "TITO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-31",
"last_updated": "2019-12-10",
"certification_date": "2019-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9112704",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCCPA FLORIDA STATE LICENSE",
"identifier": "9112704",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.