Individual provider Active NPI

Nathalia Velasquez, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • Little Neck, NY
National Provider Identifier
1043872237
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
023576-01 Issued in NY
Practice address
25510 Iowa Rd
Little Neck, NY 11362-1425
Phone
(516) 946-7710
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 023576-01 NY Primary

Addresses

Primary practice location

25510 Iowa Rd
Little Neck, NY 11362-1425

Mailing address

25510 Iowa Rd
Little Neck, NY 11362-1425
Phone (516) 946-7710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200505003137 NY Practitioner - Physician Assistant 6103257241 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
023576NYMDSpeech-Language Pathologist
023576-01NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine CurrentSince Jul 25, 2022 Accepting new patients
Fpa Hospital Based CurrentSince Mar 1, 2020 Accepting new patients
Mount Sinai School of Medicine CurrentSince Jul 25, 2022 Accepting new patients

Locations

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

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.

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1043872237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25510 IOWA RD",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621425",
            "telephone_number": "516-946-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25510 IOWA RD",
            "city": "LITTLE NECK",
            "state": "NY",
            "postal_code": "113621425",
            "telephone_number": "516-946-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "NATHALIA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "023576-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Neck, NY

Sources for this page

Verify at the official NPI Registry.