Individual provider Active NPI

Fernando Jose Veliz, PA-C

  • Physician Assistant
  • Levittown, NY
National Provider Identifier
1528624194
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023472 Issued in NY
Practice address
304 Taylor Ave
Levittown, NY 11756-5608
Phone
(516) 776-4713
NPI assigned
May 19, 2019
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 023472 NY Primary

Addresses

Primary practice location

304 Taylor Ave
Levittown, NY 11756-5608

Mailing address

761 Merrick Ave
Westbury, NY 11590-6608
Phone (516) 357-8777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200413002361 NY Practitioner - Physician Assistant 1850721952 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
023472NYMDPsychologist

Interoperability endpoints

  • Direct secure messaging: fveliz346376@nyumc.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1558224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1528624194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 MERRICK AVE",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115906608",
            "telephone_number": "516-357-8777",
            "fax_number": "516-228-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 TAYLOR AVE",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117565608",
            "telephone_number": "516-776-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELIZ",
        "first_name": "FERNANDO",
        "middle_name": "JOSE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-19",
        "last_updated": "2024-08-02",
        "certification_date": "2024-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Levittown, NY

Sources for this page

Verify at the official NPI Registry.