Active NPI
Robert Phillip Velarde, PT
- Physical Therapist
- Grants, NM
National Provider Identifier
1316097744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2744
- Practice address
- 401 N 2ND St
Grants, NM 87020-2507 - Phone
- (505) 285-2614
- Fax
- (505) 287-8487
- NPI assigned
- Jan 10, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2744 | NM | Primary |
Addresses
Primary practice location
401 N 2ND St
Grants, NM 87020-2507
Mailing address
6128 Via Corta del Sur NW
Albuquerque, NM 87120-5014
Phone (505) 899-3532
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43637850 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2744 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grants-Cibola County Schools | Past | Accepting new patients | |
| Bayada Home Health Care, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Local Education Agency (LEA)
- Grants, NM
- NPI 1043376809
-
- Home Health Agency
- Raleigh, NC
- NPI 1285876250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316097744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6128 VIA CORTA DEL SUR NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871205014",
"telephone_number": "505-899-3532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 N 2ND ST",
"city": "GRANTS",
"state": "NM",
"postal_code": "870202507",
"telephone_number": "505-285-2614",
"fax_number": "505-287-8487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELARDE",
"first_name": "ROBERT",
"middle_name": "PHILLIP",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "2744",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43637850",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grants, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.