Individual provider Active NPI

Hetalben Naginbhai Vellanki, FNP

  • Family Nurse Practitioner
  • Fremont, CA
National Provider Identifier
1477202208
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95019987 Issued in CA
Practice address
39141 Civic Center Dr Ste 130
Fremont, CA 94538-5831
Phone
(510) 248-1680
NPI assigned
Mar 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95019987 CA Primary

Addresses

Primary practice location

39141 Civic Center Dr Ste 130
Fremont, CA 94538-5831

Mailing address

39300 Civic Center Dr Ste 370
Fremont, CA 94538-2397
Phone (510) 248-1000

Other names 1

  • Hetal Vellanki Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221107002289 CA Practitioner - Nurse Practitioner 1254708183 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

39141 Civic Ctr Dr
Suite 130
Fremont, CA 94538-5831
Phone (510) 791-1005

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.74 of 100Reported as group
Quality
66.48
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95031220CAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Township Medical Foundation CurrentSince Sep 30, 2024 Accepting new patients
Brighter Beginnings CurrentSince Aug 30, 2022 Accepting new patients
Brighter Beginnings CurrentSince Aug 30, 2022 Accepting new patients
Washington Township Medical Foundation CurrentSince Sep 30, 2024 Accepting new patients
Washington Township Medical Group Past Accepting new patients

Locations

3505 Lone Tree Way
Ste 1
Antioch, CA 94509
Phone (925) 303-4780

39141 Civic Center Dr
Ste 130
Fremont, CA 94538
Phone (510) 248-1680

39500 Fremont Blvd
Ste 100
Fremont, CA 94538
Phone (510) 248-1800

39300 Civic Center Dr
Ste 370
Fremont, CA 94538
Phone (510) 248-1000

2727 Macdonald Ave
Richmond, CA 94804
Phone (510) 213-6681

Interoperability endpoints

  • Direct secure messaging: hvellanki151802@direct.whhs.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1477202208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39300 CIVIC CENTER DR STE 370",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382397",
            "telephone_number": "510-248-1000",
            "fax_number": "510-792-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39141 CIVIC CENTER DR STE 130",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945385831",
            "telephone_number": "510-248-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELLANKI",
        "first_name": "HETALBEN",
        "middle_name": "NAGINBHAI",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HETAL",
            "last_name": "VELLANKI",
            "credential": "FNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

Verify at the official NPI Registry.