Individual provider Active NPI

Melania Velasquez, PA

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1770917833
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3675 J Dewey Gray Cir
Ste. 300
Augusta, GA 30909-1868
Phone
(706) 863-9595
Fax
(706) 868-8375
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

3675 J Dewey Gray Cir
Ste. 300
Augusta, GA 30909-1868

Mailing address

1120 15TH St
Ste Bi1056
Augusta, GA 30912-0004
Phone (706) 721-3813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131120001731 GA Practitioner - Physician Assistant 2567698608 Reassigns benefits to 6 organizations
I20140718000604 SC Practitioner - Physician Assistant 2567698608 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLC 3,059 clinicians

Practice addresses (Care Compare)

2834 Hillcreek Dr
Augusta, GA 30909-5628
Phone (762) 375-5901

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2074SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Au Medical Associates Inc CurrentSince Feb 1, 2017 Accepting new patients
Au Medical Associates Inc CurrentSince Feb 1, 2017 Accepting new patients
Georgia Em-I Medical Services, LLC Physician Assistant CurrentSince Apr 6, 2018 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
The Longstreet Clinic PC Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

2834 Hillcreek Dr
Augusta, GA 30909
Phone (706) 860-4004

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

4300 University Pkwy
Evans, GA 30809
Phone (706) 721-8614

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

Organizations & group practices 11

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": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1770917833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "address_2": "STE BI1056",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 J DEWEY GRAY CIR",
            "address_2": "STE. 300",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091868",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "MELANIA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.