Individual provider Active NPI

Fortino Velasco IV, MD

  • Neurology Physician
  • San Antonio, TX
National Provider Identifier
1720616667
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
W5605 Issued in TX
Practice address
4940 Charles Katz FL 4
San Antonio, TX 78229-1911
Phone
(210) 450-9700
Fax
(210) 450-6039
NPI assigned
Mar 27, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X W5605 TX Primary

Addresses

Primary practice location

4940 Charles Katz FL 4
San Antonio, TX 78229-1911

Mailing address

4940 Charles Katz FL 4
San Antonio, TX 78229-1911
Phone (210) 450-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200429002580 NC Order and Referring Only - NeurologyPractitioner - Internal MedicinePractitioner - Neurology 0446680748
I20240523000871 GA Order and Referring Only - NeurologyPractitioner - Neurology 0446680748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
W5605TXMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1720616667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4940 CHARLES KATZ FL 4",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782291911",
            "telephone_number": "210-450-9700",
            "fax_number": "210-450-6039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 CHARLES KATZ FL 4",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782291911",
            "telephone_number": "210-450-9700",
            "fax_number": "210-450-6039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "FORTINO",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "W5605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.