Individual provider Active NPI

Marianne Velasquez, FNP-C

  • Family Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1194373654
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142518 Issued in TX
Practice address
9650 Kenworthy St
El Paso, TX 79924-6011
Phone
(915) 751-0967
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP142518 TX Primary

Addresses

Primary practice location

9650 Kenworthy St
El Paso, TX 79924-6011

Mailing address

1275 Trail Ridge Dr
El Paso, TX 79912-7345
Phone (915) 309-7871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240318002482 TX Practitioner - Nurse Practitioner 9335586080 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP142518TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dominion Medical Services, PLLC CurrentSince Feb 6, 2024 Accepting new patients

Locations

1030 N Zaragoza Rd
Ste X
El Paso, TX 79907
Phone (915) 881-4155

9650 Kenworthy St
El Paso, TX 79924
Phone (915) 751-0967

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": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1194373654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 TRAIL RIDGE DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127345",
            "telephone_number": "915-309-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 KENWORTHY ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799246011",
            "telephone_number": "915-751-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "MARIANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.