Individual provider Active NPI

Elizabeth De la Riva-Velasco, M.D.

  • Pediatric Pulmonology Physician
  • Hawthorne, NY
National Provider Identifier
1275860611
Registry record updated Jul 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
243945 Issued in NY
Practice address
19 Bradhurst Ave
Suite 1400
Hawthorne, NY 10532-2140
Phone
(914) 493-7585
Fax
(914) 594-4336
NPI assigned
Nov 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 243945 NY Primary

Addresses

Primary practice location

19 Bradhurst Ave
Suite 1400
Hawthorne, NY 10532-2140

Mailing address

22 Saw Mill River Rd
2ND Floor
Hawthorne, NY 10532-1533
Phone (914) 493-7585

Other identifiers 1

IdentifierTypeStateIssuer
03249832MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101015001000 NY Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 7911190418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Pulmonary Disease
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston Children'S Health Physicians LLPGroup PAC ID 8325937014, 80 clinicians

Practice addresses (Care Compare)

19 Bradhurst Ave
Hawthorne, NY 10532-2140
Phone (914) 493-7235

212 Crystal Run Rd
Middletown, NY 10941-4009
Phone (845) 703-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
243945NYMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Childrens Health Physicians LLP CurrentSince Aug 1, 2010 Accepting new patients
Boston Children'S Health Physicians, LLP Pediatric Pulmonology CurrentSince Aug 1, 2010 Accepting new patients
Westchester County Health Care Corporation Past Accepting new patients

Locations

22 Saw Mill River Rd
Ste 2
Hawthorne, NY 10532
Phone (914) 593-1606

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

19 Bradhurst Ave
Ste 1400
Hawthorne, NY 10532
Phone (914) 493-7997

212 Crystal Run Rd
#1
Middletown, NY 10941

257 Lafayette Ave
Ste 370
Suffern, NY 10901
Phone (914) 304-5300

40 Sunshine Cottage Rd
Ofc 1ND
Valhalla, NY 10595

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: elizabeth.delarivavelasco.p1@direct.cwpw.nextgenshare.com

Organizations & group practices 3

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": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1275860611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SAW MILL RIVER RD",
            "address_2": "2ND FLOOR",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105321533",
            "telephone_number": "914-493-7585",
            "fax_number": "914-594-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BRADHURST AVE",
            "address_2": "SUITE 1400",
            "city": "HAWTHORNE",
            "state": "NY",
            "postal_code": "105322140",
            "telephone_number": "914-493-7585",
            "fax_number": "914-594-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA RIVA-VELASCO",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-05",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "243945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03249832",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NY

Sources for this page

Verify at the official NPI Registry.