Individual provider Active NPI

Madeleine Ong-Veloso, N.P.

  • Family Nurse Practitioner
  • Victorville, CA
National Provider Identifier
1629027305
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
327778 Issued in CA
Practice address
12550 Hesperia Road
Suite 100
Victorville, CA 92395-0000
Phone
(760) 241-6666
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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 327778 CA Primary

Addresses

Primary practice location

12550 Hesperia Road
Suite 100
Victorville, CA 92395-0000

Mailing address

17095 Main St
Hesperia, CA 92345-0000
Phone (760) 241-6666

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mongveloso1373336@oc.providencedirect.org

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
I20081202000085 CA Practitioner - Nurse Practitioner 2567523103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

12550 Hesperia Rd
Suite 100
Victorville, CA 92395-5873
Phone (760) 241-6666

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
327778CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jul 1, 2013 Accepting new patients
Providence Medical Foundation CurrentSince Jul 1, 2013 Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Victor Valley Community Hospital Past Accepting new patients
St. Mary Medical Center Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

17095 Main St
Hesperia, CA 92345
Phone (760) 948-6606

17095 Main St
#A
Hesperia, CA 92345

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

12550 Hesperia Rd
Ste 100
Victorville, CA 92395

Interoperability endpoints

  • Direct secure messaging: mongveloso1373336@oc.providencedirect.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1629027305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17095 MAIN ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923450000",
            "telephone_number": "760-241-6666",
            "fax_number": "760-241-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 HESPERIA ROAD",
            "address_2": "SUITE 100",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923950000",
            "telephone_number": "760-241-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG-VELOSO",
        "first_name": "MADELEINE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "327778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mongveloso1373336@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12550 Hesperia Road",
            "address_2": "Suite 100",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923950000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.