Individual provider Active NPI

Jesica Christine Velez

  • Behavior Analyst
  • Pompano Beach, FL
National Provider Identifier
1023412236
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-1830460 Issued in FL
Practice address
911 East Atlantic Bulevard #108a
Pompano Beach, FL 33060
Phone
(954) 941-2323
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-1830460 FL Primary

Addresses

Primary practice location

911 East Atlantic Bulevard #108a
Pompano Beach, FL 33060

Mailing address

911 E Atlantic Blvd Ste 108a
Pompano Beach, FL 33060-7372
Phone (786) 262-5953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1-1830460FLMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Reveresco ABA Therapy, LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1023412236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 E ATLANTIC BLVD STE 108A",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330607372",
            "telephone_number": "786-262-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 EAST ATLANTIC BULEVARD #108A",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "33060",
            "telephone_number": "954-941-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ",
        "first_name": "JESICA",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-1830460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.