Individual provider Active NPI

Kevin Tomassini Velez, DC

  • Chiropractor
  • San Carlos, CA
National Provider Identifier
1083962237
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
36726 Issued in CA
Practice address
1200 Brittan Ave
San Carlos, CA 94070-3931
Phone
(650) 591-1002
NPI assigned
Aug 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 12116 TX
Chiropractor 111N00000X 36726 CA Primary

Addresses

Primary practice location

1200 Brittan Ave
San Carlos, CA 94070-3931

Mailing address

1200 Brittan Ave
San Carlos, CA 94070-3931
Phone (650) 591-1002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240214002991 CA Practitioner - Chiropractic 3577907872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bailey Cruze Premier Health Chiropractic, Inc.Group PAC ID 5597136804, 8 clinicians

Practice addresses (Care Compare)

2001 Union St
Suite 440
San Francisco, CA 94123-4109
Phone (415) 523-9367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12116TXMDAddiction (Substance Use Disorder) Counselor
36726CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bailey Cruze Premier Health Chiropractic, Inc. Chiropractor CurrentSince Jan 24, 2024 Accepting new patients
Bayside Chiropractic, Sprague & Chiu Chiropractor CurrentSince Oct 29, 2023 Accepting new patients
Dr Arlan W Young DC Chiropractic Corp Chiropractor PastSince Oct 29, 2023 Accepting new patients
Johnston Healthcare Enterprises, LLC Chiropractor Past Accepting new patients

Locations

1200 Brittan Ave
San Carlos, CA 94070
Phone (650) 591-1002

582 Market St
Ste 403
San Francisco, CA 94104
Phone (415) 236-1810

168 Sanchez St
San Francisco, CA 94114
Phone (415) 236-1810

2001 Union St
Ste 440
San Francisco, CA 94123
Phone (415) 236-1810

Organizations & group practices 4

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": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1083962237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BRITTAN AVE",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703931",
            "telephone_number": "650-591-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BRITTAN AVE",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940703931",
            "telephone_number": "650-591-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASSINI VELEZ",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-20",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12116",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "36726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Carlos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.