NPIMap

Individual provider Active NPI

Estrelino D Velasco Jr., MD

  • Family Medicine Physician
  • Milton, WA
National Provider Identifier
1407889660
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00040660 Issued in WA
Practice address
2748 Milton Way
Ste 101
Milton, WA 98354-9382
Phone
(253) 922-5262
Fax
(253) 922-5299
NPI assigned
Jul 9, 2006
Last updated
Mar 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00040660 WA Primary

Addresses

Primary practice location

2748 Milton Way
Ste 101
Milton, WA 98354-9382

Mailing address

2748 Milton Way
Ste 101
Milton, WA 98354-9382
Phone (253) 922-5262

Other identifiers 1

IdentifierTypeStateIssuer
0301420OtherWASTATE L&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070524000693 WA Practitioner - Family Practice 9830296946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

2748 Milton Way
Suite 101
Milton, WA 98354-9379
Phone (253) 922-5262

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00040660WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Mar 15, 2013 Accepting new patients
Franciscan Medical Group Family Medicine CurrentSince Mar 15, 2013 Accepting new patients
Franciscan Medical Group Family Medicine Past Accepting new patients
Federal Way Primary Care, LLC PastSince Nov 16, 2007 Accepting new patients

Locations

1175 Center Dr
Ste 130
DuPont, WA 98327
Phone (253) 964-5260

3021 Griffin Ave
Enumclaw, WA 98022
Phone (253) 833-6241

34503 9th Ave S
Ste 100
Federal Way, WA 98003
Phone (253) 835-8700

6040 20th St E
#A
Fife, WA 98424
Phone (253) 922-5262

2748 Milton Way
Ste 101
Milton, WA 98354
Phone (253) 922-5262

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: evelasco15791@fhsce.catholichealth.net

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1407889660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2748 MILTON WAY",
            "address_2": "STE 101",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983549382",
            "telephone_number": "253-922-5262",
            "fax_number": "253-922-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2748 MILTON WAY",
            "address_2": "STE 101",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983549382",
            "telephone_number": "253-922-5262",
            "fax_number": "253-922-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "ESTRELINO",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00040660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0301420",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, WA

Sources for this page

Verify at the official NPI Registry.