Individual provider Active NPI

Elsa Tamara Fuentes-Velazquez

  • Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1174475495
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
254628 Issued in AZ
Practice address
1514 W Thomas Rd
Phoenix, AZ 85015-6101
Phone
(602) 283-5732
NPI assigned
Feb 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 254628 AZ Primary

Addresses

Primary practice location

1514 W Thomas Rd
Phoenix, AZ 85015-6101

Mailing address

1514 W Thomas Rd
Phoenix, AZ 85015-6101
Phone (602) 283-5732

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260330003338 AZ Practitioner - Nurse Practitioner 7911482716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1514 W Thomas Rd
Phoenix, AZ 85015-6101

2045 S Vineyard
Suite 123
Mesa, AZ 85210-6893

3602 W Palmaire Ave
Phoenix, AZ 85051-8241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
254628AZMDNurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1174475495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850156101",
            "telephone_number": "602-283-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850156101",
            "telephone_number": "602-283-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES-VELAZQUEZ",
        "first_name": "ELSA",
        "middle_name": "TAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "254628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.