Individual provider Active NPI

Carmen Velazquez, MD

  • Internal Medicine Physician
  • Elgin, IL
National Provider Identifier
1518965714
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
04532225OtherILBLUE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110215000604 CA Practitioner - Internal Medicine 9436108404 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
56153CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
036101897ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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 CurrentSince Aug 31, 2016 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.