Individual provider Active NPI

Veronica Valentina Velasquez

  • Student in an Organized Health Care Education/Training Program
  • New Haven, CT
National Provider Identifier
1366011702
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-4242
NPI assigned
Jun 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125079028 IL
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242

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

LicenseStateTypeSpecialty
125079028ILMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

Interoperability endpoints

  • Direct secure messaging: vvelasquez139952@direct.luhs.org

Organizations & group practices 1

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": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1366011702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "VERONICA",
        "middle_name": "VALENTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125079028",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.