Individual provider Active NPI

Elvis Lamotte Velez, PHYSICAL THERAPIST

  • Physical Therapist
  • West New York, NJ
National Provider Identifier
1053472654
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00525200 Issued in NJ
Practice address
4914 Kennedy Blvd
Suite 204
West New York, NJ 07093-5590
Phone
(201) 974-1433
Fax
(206) 974-1437
NPI assigned
Dec 13, 2006
Last updated
Mar 24, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00525200 NJ Primary
Physical Therapist 225100000X 0224901 NY

Addresses

Primary practice location

4914 Kennedy Blvd
Suite 204
West New York, NJ 07093-5590

Mailing address

4914 Kennedy Blvd
Suite 204
West New York, NJ 07093-5590
Phone (201) 974-1433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615001215 NJ Practitioner - Physical Therapist in Private Practice 7214839331 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00525200NJMDPhysical Therapist
0224901NYMDPhysical Therapist
022490NYMDSpeech-Language Pathologist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1053472654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 KENNEDY BLVD",
            "address_2": "SUITE 204",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935590",
            "telephone_number": "201-974-1433",
            "fax_number": "206-974-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 KENNEDY BLVD",
            "address_2": "SUITE 204",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935590",
            "telephone_number": "201-974-1433",
            "fax_number": "206-974-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMOTTE VELEZ",
        "first_name": "ELVIS",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00525200",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0224901",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.