Active NPI
Carmen Velazquez, MD
- Internal Medicine Physician
- Elgin, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Practice address
- 1185 Dundee Ave
Suite C
Elgin, IL 60120-2232 - Phone
- (847) 931-0303
- Fax
- (847) 931-5230
- NPI assigned
- Jul 12, 2005
- Last updated
- Feb 5, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | IL | Primary |
Addresses
Primary practice location
1185 Dundee Ave
Suite C
Elgin, IL 60120-2232
Mailing address
1185 Dundee Ave
Suite C
Elgin, IL 60120-2232
Phone (847) 931-0303
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04532225 | Other | IL | BLUE CROSS BLUE SHIELD |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1637 3Rd Ave
Chula Vista, CA 91911-5823
Phone (619) 662-4100
2400 E 8TH St
National City, CA 91950-2956
Phone (619) 662-4100
4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 428-4463
4050 Beyer Blvd
San Ysidro, CA 92173-2007
Phone (619) 662-4100
678 3Rd Ave
Chula Vista, CA 91910-5736
Phone (619) 662-4100
875 El Cajon Blvd
El Cajon, CA 92020-5714
Phone (619) 662-4100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56153 | CA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 036101897 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Current | Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro Inc | Current | Accepting new patients | |
| Centro de Salud de la Comunidad de San Ysidro, Inc. | Past | Accepting new patients | |
| Advocate Sherman Hospital | Past | Accepting new patients | |
| Scripps Health | Past | Accepting new patients |
Locations
1637 Third Ave
Ste B
Chula Vista, CA 91911
Phone (619) 425-1780
678 Third Ave
Chula Vista, CA 91910
1136 D Ave
National City, CA 91950
Phone (619) 336-2300
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- cvelazquez18665@syhealth.direct-ci.com
Organizations & group practices 6
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.
-
dba San Ysidro Health Precision Park
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1124782685
-
- Internal Medicine Physician
- Elgin, IL
- NPI 1548295108
-
dba San Ysidro Health Senior Dental Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1457033813
-
- General Acute Care Hospital
- Elgin, IL
- NPI 1629026364
-
dba San Ysidro Health National City
- Federally Qualified Health Center (FQHC)
- National City, CA
- NPI 1003869363
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": "1121126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202169600000",
"number": "1518965714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1185 DUNDEE AVE",
"address_2": "SUITE C",
"city": "ELGIN",
"state": "IL",
"postal_code": "601202232",
"telephone_number": "847-931-0303",
"fax_number": "847-931-5230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1185 DUNDEE AVE",
"address_2": "SUITE C",
"city": "ELGIN",
"state": "IL",
"postal_code": "601202232",
"telephone_number": "847-931-0303",
"fax_number": "847-931-5230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELAZQUEZ",
"first_name": "CARMEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-12",
"last_updated": "2008-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "04532225",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.