Ismarie Velazquez

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

058735 Issued in NY

Practice address

111 E 210TH St
Montefiore Medical Center Dept of Dentistry
Bronx, NY 10467-2401

Phone

(718) 920-6039

NPI assigned

Apr 9, 2015

Last updated

Jul 17, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ivelazqu@montefioredirect.com

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.

• Connecticut Institute for Communities Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1780918045
  Medicare reassignment NPD
• Connecticut Institute for Communities Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1528499969
  NPD
• Connecticut Institute for Communities Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1215431234
  NPD (past)

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1720474315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 CARR 112",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "00662",
            "telephone_number": "787-552-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "address_2": "MONTEFIORE MEDICAL CENTER DEPT OF DENTISTRY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "ISMARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-09",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Velasserry, LMSW
• Nerissa K Velazco, MD
• Maria Velazquez-Connor, MD
• Edna Velazquez, RPH
• Franklin Velazquez, LCSW
• Neida M. Velazquez, LCSW-R
• Rosario Velazquez, LMSW
• Steve Andrew Velazquez
• Victoria Velazquez
• Karen Velez Huerta

• General Practice Dentistry in Bronx, NY
• Providers in Bronx, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.