Individual provider Active NPI

George Velasco, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1740819671
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
325221 Issued in NY
Practice address
2771 Frederick Douglass Blvd
New York, NY 10039-3027
Phone
(212) 690-0303
NPI assigned
Apr 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 325221 NY Primary

Addresses

Primary practice location

2771 Frederick Douglass Blvd
New York, NY 10039-3027

Mailing address

1 Gustave L Levy PL # 1118
New York, NY 10029-6504

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230914003468 NY Practitioner - Internal Medicine 7113337775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Amsterdam Ave
New York, NY 10025-1716
Phone (212) 523-6500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
325221NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Sep 1, 2023 Accepting new patients
Icahn School of Medicine at Mount Sinai Current Accepting new patients

Locations

2771 Frederick Douglass Blvd
New York, NY 10039
Phone (212) 690-0303

17 E 102nd St
New York, NY 10029
Phone (212) 241-7968

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Organizations & group practices 3

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": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1740819671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL # 1118",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 FREDERICK DOUGLASS BLVD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100393027",
            "telephone_number": "212-690-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-02",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "325221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.