Individual provider Active NPI

Yudil Holanda Velez, M.D.

  • Pediatrics Physician
  • Norwalk, CT
National Provider Identifier
1407218753
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
69047 Issued in CT
Practice address
120 Connecticut Ave
Norwalk, CT 06854-1525
Phone
(203) 899-1770
NPI assigned
Mar 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 69047 CT Primary

Addresses

Primary practice location

120 Connecticut Ave
Norwalk, CT 06854-1525

Mailing address

120 Connecticut Ave
Norwalk, CT 06854-1525
Phone (203) 899-1770

Other practice location 1

743 E 181st St Fl 1
Bronx, NY 10457-2749
Phone (917) 635-5608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, CA2 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
I20210920000912 CT Practitioner - Pediatric Medicine 3173920147 Reassigns benefits to 1 organization
I20230724001561 CA Practitioner - Pediatric Medicine 3173920147 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
300397NYMDLicensed Practical Nurse
69047CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norwalk Community Health Center Inc CurrentSince Jul 26, 2021 Accepting new patients
Via Care Community Health Center CurrentSince May 12, 2023 Accepting new patients
Via Care Community Health Center CurrentSince May 12, 2023 Accepting new patients

Locations

501 S Atlantic Blvd
Los Angeles, CA 90022
Phone (323) 268-5442

507 S Atlantic Blvd
Los Angeles, CA 90022
Phone 32326891911067

120 Connecticut Ave
Norwalk, CT 06854
Phone (203) 851-1000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCDGCD

Organizations & group practices 3

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": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1407218753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 CONNECTICUT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541525",
            "telephone_number": "203-899-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 CONNECTICUT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541525",
            "telephone_number": "203-899-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "743 E 181st St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104572749",
            "country_code": "US",
            "telephone_number": "917-635-5608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELEZ",
        "first_name": "YUDIL",
        "middle_name": "HOLANDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "69047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.