Individual provider Active NPI

Elmo Campos Velazquez, PH.D

  • Psychologist
  • Bayamon, PR
National Provider Identifier
1750458196
Registry record updated Nov 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
000852 Issued in PR
Practice address
Ave. Espiritu Savito No 1 Rio Hondo
Bayamon, PR 00961-3113
Phone
(787) 795-0280
Fax
(787) 795-0280
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 000852 PR Primary

Addresses

Primary practice location

Ave. Espiritu Savito No 1 Rio Hondo
Bayamon, PR 00961-3113

Mailing address

Suite 444 PMB 90 Ave Rio Hondo
Bayamon, PR 00961-3113
Phone (787) 795-0280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
852PRMDSports Physician Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1750458196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SUITE 444 PMB 90 AVE RIO HONDO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009613113",
            "telephone_number": "787-795-0280",
            "fax_number": "787-795-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. ESPIRITU SAVITO NO 1 RIO HONDO",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009613113",
            "telephone_number": "787-795-0280",
            "fax_number": "787-795-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS VELAZQUEZ",
        "first_name": "ELMO",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PR",
            "license": "000852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.