Individual provider Active NPI

Victoria I Felkl, MD

  • Psychiatry Physician
  • Manchester, NH
National Provider Identifier
1376969824
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
18660 Issued in NH
Practice address
2 Wall St Ste 400
Manchester, NH 03101
Phone
(603) 668-4111
NPI assigned
Mar 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A138187 CA
Psychiatry Physician 2084P0800X 18660 NH Primary

Addresses

Primary practice location

2 Wall St Ste 400
Manchester, NH 03101

Mailing address

2 Wall St Ste 300
Manchester, NH 03101-1518
Phone (603) 668-4111

Other practice location 1

1000 W Carson St
Box 498
Torrance, CA 90502-2004
Phone (310) 222-3110

Other names 1

  • Victoria Isabel Marroquin Diaz Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180806001709 NH Practitioner - Psychiatry 8022366178
I20220315002561 TX Practitioner - Psychiatry 8022366178 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A138187CAMDSpecialist
18660NHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Clinical Current Accepting new patients
Tri-County Clinical CurrentSince Jan 31, 2022 Accepting new patients

Locations

4900 Mueller Blvd
#2S
Austin, TX 78723
Phone (512) 324-3315

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

Interoperability endpoints

  • Direct secure messaging: victoria.felkl.1@8363.direct.athenahealth.com

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": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1376969824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WALL ST STE 300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WALL ST STE 400",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03101",
            "telephone_number": "603-668-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St",
            "address_2": "Box 498",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "310-222-3110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELKL",
        "first_name": "VICTORIA",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A138187",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "18660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TheMentalHealthCenterofGreaterManchester@mhcgm.netsmartdirect.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2 Wall St Ste 400",
            "city": "Manchester",
            "state": "NH",
            "country_code": "US",
            "postal_code": "03101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "MARROQUIN DIAZ",
            "middle_name": "ISABEL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.