Individual provider Active NPI

Emilia Velazquez, MSPT

  • Physical Therapist
  • Morganville, NJ
National Provider Identifier
1245328715
Registry record updated Dec 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00678300 Issued in NJ
Practice address
21 Kilmer Dr
BLDG. 2 Suite D
Morganville, NJ 07751-1571
Phone
(732) 851-7607
Fax
(732) 851-7610
NPI assigned
Oct 10, 2006
Last updated
Dec 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00678300 NJ Primary

Addresses

Primary practice location

21 Kilmer Dr
BLDG. 2 Suite D
Morganville, NJ 07751-1571

Mailing address

302 Autumn Hill Dr
Morganville, NJ 07751-2043
Phone (732) 589-0550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070418000589 NJ Practitioner - Physical Therapist in Private Practice 2769587880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40QA00678300NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Corrective Care Group PC Physical Therapist PastSince Feb 23, 2006 Accepting new patients
No Tears Dental Center, P.C. Past Accepting new patients
Northeast Spine & Wellness Center LLC Physical Therapist PastSince May 20, 2005 Accepting new patients

Organizations & group practices 4

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1245328715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 AUTUMN HILL DR",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077512043",
            "telephone_number": "732-589-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 KILMER DR",
            "address_2": "BLDG. 2 SUITE D",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511571",
            "telephone_number": "732-851-7607",
            "fax_number": "732-851-7610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "EMILIA",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00678300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.