Individual provider Active NPI

Ivonne Velado, PA-C

  • Physician Assistant
  • East Palo Alto, CA
National Provider Identifier
1154370963
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16275 Issued in CA
Practice address
1798 Bay Rd Ste a
East Palo Alto, CA 94303-5312
Phone
(650) 321-0980
Fax
(650) 321-0988
NPI assigned
May 9, 2006
Last updated
Mar 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16275 CA Primary

Addresses

Primary practice location

1798 Bay Rd Ste a
East Palo Alto, CA 94303-5312

Mailing address

1798 Bay Rd Ste a
East Palo Alto, CA 94303-5312
Phone (650) 321-0980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040913000762 CA Practitioner - Physician Assistant 9436126117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1796 Bay Rd
BLDG 2
East Palo Alto, CA 94303-1611

1798 A Bay Rd
East Palo Alto, CA 94303-5312

1798 Bay Rd
Suite a
East Palo Alto, CA 94303-5312
Phone (650) 330-7400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16275CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South County Community Health Center Inc CurrentSince May 22, 2011 Accepting new patients

Locations

1798 Bay Rd
Ste A
East Palo Alto, CA 94303
Phone (650) 330-7400

1885 Bay Rd
East Palo Alto, CA 94303
Phone (650) 330-7400

Organizations & group practices 2

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1154370963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1798 BAY RD STE A",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943035312",
            "telephone_number": "650-321-0980",
            "fax_number": "650-321-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1798 BAY RD STE A",
            "city": "EAST PALO ALTO",
            "state": "CA",
            "postal_code": "943035312",
            "telephone_number": "650-321-0980",
            "fax_number": "650-321-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELADO",
        "first_name": "IVONNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Palo Alto, CA

Sources for this page

Verify at the official NPI Registry.