Individual provider Active NPI

Pattijo N Velasquez, PH.D.

  • Prescribing (Medical) Psychologist
  • Las Cruces, NM
National Provider Identifier
1730203860
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
0051C Issued in NM
Practice address
1505 S Don Roser Dr
Ste. a
Las Cruces, NM 88011-4596
Phone
(575) 636-2506
Fax
(888) 854-0782
NPI assigned
Mar 16, 2007
Last updated
Apr 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) Psychologist 103TP0016X 0051C NM Primary

Addresses

Primary practice location

1505 S Don Roser Dr
Ste. a
Las Cruces, NM 88011-4596

Mailing address

1505 S Don Roser Dr
Ste. a
Las Cruces, NM 88011-4596
Phone (575) 636-2506

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141023001647 NM Practitioner - Clinical Psychologist 7113992181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inetmed RX2 Inc.Group PAC ID 2062796709, 7 clinicians

Practice addresses (Care Compare)

1635 S Don Roser Dr
Las Cruces, NM 88011-4550
Phone (575) 636-2506

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0051CNMMDPrescribing (Medical) Psychologist
1278NMMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Inetmed RX2 Inc. Prescribing (Medical) CurrentSince Jan 15, 2017 Accepting new patients
Inetmed RX2 Inc. Prescribing (Medical) Current Accepting new patients

Locations

1505 S Don Roser Dr
Ste A
Las Cruces, NM 88011
Phone (575) 521-3388

1635 S Don Roser Dr
Las Cruces, NM 88011
Phone (575) 522-1241

1635 S Don Roser Dr
Ste A
Las Cruces, NM 88011
Phone (575) 635-2506

Organizations & group practices 2

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1730203860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 S DON ROSER DR",
            "address_2": "STE. A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114596",
            "telephone_number": "575-636-2506",
            "fax_number": "888-854-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 S DON ROSER DR",
            "address_2": "STE. A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114596",
            "telephone_number": "575-636-2506",
            "fax_number": "888-854-0782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "PATTIJO",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "NM",
            "license": "0051C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.