Individual provider Active NPI

Dhyana Velasco, M.D.

  • Obstetrics & Gynecology Physician
  • Albuquerque, NM
National Provider Identifier
1295120509
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD2019-0767 Issued in NM
Practice address
4705 Montgomery Blvd NE Ste 301
Albuquerque, NM 87109-1234
Phone
(505) 727-4500
Fax
(505) 727-4505
NPI assigned
Apr 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X MD2019-0767 NM Primary

Addresses

Primary practice location

4705 Montgomery Blvd NE Ste 301
Albuquerque, NM 87109-1234

Mailing address

1013 Girard Blvd NE
Albuquerque, NM 87106-2014

Other practice location 1

4800 Alberta Ave
OBGYN Dept.
El Paso, TX 79905-2709
Phone (915) 215-5020

Other identifiers 1

IdentifierTypeStateIssuer
72122731MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20191001001327 NM Practitioner - Obstetrics/Gynecology 8224368451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of New Mexico School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

4705 Montgomery Blvd NE
Suite 301
Albuquerque, NM 87109-1234
Phone (505) 727-4500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Sep 16, 2019 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Sep 16, 2019 Accepting new patients
Lovelace Health System, LLC Past Accepting new patients

Locations

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

4801 McMahon Blvd NW
Ste 101
Albuquerque, NM 87114
Phone (505) 269-7349

4705 Montgomery Blvd NE
Ste 301
Albuquerque, NM 87109
Phone (505) 727-4500

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

Interoperability endpoints

  • Direct secure messaging: dvelasco275231@ahs.direct-ci.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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1295120509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 GIRARD BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 MONTGOMERY BLVD NE STE 301",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091234",
            "telephone_number": "505-727-4500",
            "fax_number": "505-727-4505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Alberta Ave",
            "address_2": "OBGYN Dept.",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052709",
            "country_code": "US",
            "telephone_number": "915-215-5020",
            "fax_number": "915-545-6946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "DHYANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2019-0767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72122731",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.