NPIMap

Individual provider Active NPI

Angelo Ong-Veloso Jr., M.D.

  • Internal Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1124020284
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26164 Issued in AZ
Practice address
1840 Mesquite Ave
Ste B
Lake Havasu City, AZ 86403-5771
Phone
(928) 453-8500
Fax
(928) 453-5556
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 26164 AZ
Internal Medicine Physician 207R00000X 26164 AZ Primary

Addresses

Primary practice location

1840 Mesquite Ave
Ste B
Lake Havasu City, AZ 86403-5771

Mailing address

1840 Mesquite Ave
Ste B
Lake Havasu City, AZ 86403-5771
Phone (928) 453-8500

Other identifiers 1

IdentifierTypeStateIssuer
110215166OtherAZRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100127000325 AZ Practitioner - Internal Medicine 7719029925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1840 Mesquite Ave
Suite B
Lake Havasu City, AZ 86403-5771
Phone (928) 453-8500

1840 Mesquite Ave B
Lake Havasu City, AZ 86403-5771

Hospital & facility affiliations

  • River Valley Home Health Home health agency, Lake Havasu, AZ, CCN 037402
  • Havasu Regional Medical Center Home Health Home health agency, Lake Havasu City, AZ, CCN 037057
  • Foundation Home Health, LLC Home health agency, Lake Havasu City, AZ, CCN 037486
  • Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069
  • La Paz Regional Hospital Hospital, Parker, AZ, CCN 031317
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055
  • Valley View Medical Center Hospital, Fort Mohave, AZ, CCN 030117
  • Havasu Nursing Center Nursing home, Lake Havasu City, AZ, CCN 035100
  • Haven of Lake Havasu Nursing home, Lake Havasu City, AZ, CCN 035240

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue133
Removal of skin lesions13
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26164AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Internal Medicine PLLC Specialist CurrentSince Jan 8, 2000 Accepting new patients
Haven of Lake Havasu, LLC Past Accepting new patients
Havasu Nursing Center 2 Inc Past Accepting new patients

Locations

2781 Osborn Dr
Lake Havasu City, AZ 86406
Phone (928) 505-5552

1840 Mesquite Ave
Ste B
Lk Havasu Cty, AZ 86403
Phone (928) 453-8500

Interoperability endpoints

  • Direct secure messaging: lhi9405@yourcarecommunity.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Havasu Nursing CenterLake Havasu City, AZ, CCN 035100 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2012
Mar 1, 2012
Haven of Lake HavasuLake Havasu City, AZ, CCN 035240 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2023
Jan 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1124020284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 MESQUITE AVE",
            "address_2": "STE B",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035771",
            "telephone_number": "928-453-8500",
            "fax_number": "928-453-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 MESQUITE AVE",
            "address_2": "STE B",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035771",
            "telephone_number": "928-453-8500",
            "fax_number": "928-453-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG-VELOSO",
        "first_name": "ANGELO",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "26164",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "26164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110215166",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.