Eduardo Antonio Marrero Velis

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

52572 Issued in AZ

Practice address

815 E 15TH St
Douglas, AZ 85607-1631

Phone

(520) 364-5437

Fax

(520) 364-4261

NPI assigned

Feb 28, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eduardo.marrerovelis.p1@direct.cchci.nextgenshare.com

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.

• Chiricahua Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Douglas, AZ
  • NPI 1942241443
  Medicare reassignment NPD
• Chiricahua Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Willcox, AZ
  • NPI 1285488866
  NPD

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

{
    "created_epoch": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1144560160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E 15TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071631",
            "telephone_number": "520-364-5437",
            "fax_number": "520-364-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRERO VELIS",
        "first_name": "EDUARDO",
        "middle_name": "ANTONIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-28",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "52572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171732",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Lindstrom, FNP
• Heidi L Lodge, MD
• Gabrielle Alexandra Lugo, ARNP
• Dia Cherie Madden, FNP
• Aman Paul Mansury, MD
• Alexis Martinez
• Tamara Danett Martinez, LPN
• Colleen Kay Mattson, MA, LPC
• Cheryl Lynn McNeeley, SPEECH LANGUAGE PATH
• Mary K McNeff, WHCNP

• Pediatrics Physician in Douglas, AZ
• Providers in Douglas, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.