Individual provider Active NPI

Audrey Milagros Veliz, PA-C

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1760203152
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033022 Issued in NY
Practice address
1065 Southern Blvd
Bronx, NY 10459-2417
Phone
(718) 589-2440
NPI assigned
Oct 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9119477 FL
Physician Assistant 363A00000X 033022 NY Primary

Addresses

Primary practice location

1065 Southern Blvd
Bronx, NY 10459-2417

Mailing address

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250911004646 NY Practitioner - Physician Assistant 3375046618 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
San Juan Bautista School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urban Health Plan IncGroup PAC ID 3173517281, 158 clinicians

Practice addresses (Care Compare)

1065 Southern Blvd
Bronx, NY 10459-2417
Phone (718) 589-2440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9119477FLMDPhysician Assistant
033022NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Urban Health Plan, Inc. CurrentSince Aug 18, 2025 Accepting new patients
Brookview Medical Associates, PLLC CurrentSince Jan 6, 2026 Accepting new patients
Urban Health Plan, Inc. Current Accepting new patients
Urban Health Plan, Inc. CurrentSince Aug 18, 2025 Accepting new patients

Locations

80 Orville Dr
Ste 100
Bohemia, NY 11716
Phone (516) 308-6610

1065 Southern Blvd
Bronx, NY 10459
Phone 71858924404222

1515 Southern Blvd
#H
Bronx, NY 10460
Phone (718) 589-1600

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 4

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": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1760203152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 SOUTHERN BLVD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104592417",
            "telephone_number": "718-589-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELIZ",
        "first_name": "AUDREY",
        "middle_name": "MILAGROS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9119477",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.