Individual provider Active NPI

Melissa Dawn Velasco, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1326736414
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3018736 Issued in KY
Practice address
4010 Dupont Cir Ste 202
Louisville, KY 40207-4847
Phone
(502) 329-3011
NPI assigned
Apr 26, 2023
Last updated
Apr 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3018736 KY Primary

Addresses

Primary practice location

4010 Dupont Cir Ste 202
Louisville, KY 40207-4847

Mailing address

4010 Dupont Cir Ste 202
Louisville, KY 40207-4847
Phone (502) 326-3011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912004381 KY Practitioner - Nurse Practitioner 8325588692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hagan Health LLCGroup PAC ID 5890129159, 8 clinicians

Practice addresses (Care Compare)

4010 Dupont Cir
Suite 202
Louisville, KY 40207-4847
Phone (502) 326-3011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Terry M. Hagan MD Psychiatric/Mental Health CurrentSince Apr 30, 2023 Accepting new patients
Hagan Health LLC Psychiatric/Mental Health CurrentSince May 11, 2024 Accepting new patients

Locations

4010 DuPont Cir
Ste 202
Louisville, KY 40207
Phone (502) 326-3011

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.

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1326736414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074847",
            "telephone_number": "502-326-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074847",
            "telephone_number": "502-329-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "MELISSA",
        "middle_name": "DAWN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3018736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.