Individual provider Active NPI

Nadia Velasquez

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1376104828
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62508 Issued in TX
Practice address
1700 Rutherford LN
Austin, TX 78754-5104
Phone
(512) 450-0844
NPI assigned
Jun 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 62508 TX Primary

Addresses

Primary practice location

1700 Rutherford LN
Austin, TX 78754-5104

Mailing address

1928 Wayward Sun Dr
Austin, TX 78754-5401
Phone (210) 268-4052

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190903000285 TX Practitioner - Clinical Social Worker 9537498464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Eldercare, Inc.Group PAC ID 6709072580, 4 clinicians

Practice addresses (Care Compare)

Austin, TX 78754
Phone (512) 843-1213

1700 Rutherford LN
Austin, TX 78754-5104
Phone (512) 483-3556

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62508TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eldercare, Inc. Clinical CurrentSince Sep 16, 2019 Accepting new patients
Luna Tides Counseling Current Accepting new patients

Locations

1700 Rutherford Ln
Austin, TX 78754
Phone (512) 450-0844

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1376104828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1928 WAYWARD SUN DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787545401",
            "telephone_number": "210-268-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RUTHERFORD LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787545104",
            "telephone_number": "512-450-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "NADIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-25",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.