Individual provider Active NPI

Jeanne Michelle Velasco, M.D.

  • Pediatrics Physician
  • Lansdale, PA
National Provider Identifier
1275852147
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD451816 Issued in PA
Practice address
1240 S Broad St Ste 130
Lansdale, PA 19446-5395
Phone
(215) 361-5040
NPI assigned
May 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X MD451816 PA
Pediatrics Physician 208000000X MD451816 PA Primary

Addresses

Primary practice location

1240 S Broad St Ste 130
Lansdale, PA 19446-5395

Mailing address

401 Route 73 N Ste 320
Marlton, NJ 08053-3426
Phone (856) 872-7055

Other identifiers 1

IdentifierTypeStateIssuer
MD451816OtherPACOMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170110001525 PA Practitioner - Pediatric Medicine 9638498389 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD451816PAMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC Pediatrics CurrentSince Dec 1, 2019 Accepting new patients
Advocare, LLC Pediatrics CurrentSince Jan 15, 2024 Accepting new patients
Advocare , LLC CurrentSince Jan 15, 2024 Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC Pediatrics Current Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients

Locations

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

1100 Horizon Cir
Ste 101
Chalfont, PA 18914
Phone (215) 394-0400

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

Interoperability endpoints

  • Direct secure messaging: jeanne.velasco@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 6

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": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1275852147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROUTE 73 N STE 320",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533426",
            "telephone_number": "856-872-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S BROAD ST STE 130",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194465395",
            "telephone_number": "215-361-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "JEANNE",
        "middle_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-18",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "PA",
            "license": "MD451816",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD451816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF STATE",
            "identifier": "MD451816",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

Verify at the official NPI Registry.