Organization Active NPI

Nelly Velasquez MD PA

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1790953271
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L8547 Issued in TX
Legal business name
NELLY VELASQUEZ MD PA
Practice address
900 E 30TH St Ste 205
Austin, TX 78705
Phone
(512) 236-1100
Fax
(512) 236-1128
NPI assigned
Feb 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Dr. Nelly Del Carmen Velasquez, M.D.NPI 1619955218
Title
President
Phone
(512) 236-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X L8547 TX Primary

Addresses

Primary practice location

900 E 30TH St Ste 205
Austin, TX 78705

Mailing address

900 E 30TH St Ste 205
Austin, TX 78705-3378
Phone (512) 236-1100

Other identifiers 1

IdentifierTypeStateIssuer
165096201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040624001678 TX Part B Supplier - Clinic/Group Practice 0446236194 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1028105Nelly Velasquez MD PA900 E 30TH Suite 200, Austin, TX 78705Certificate of waiverJul 19, 2028

National Provider Directory

National Provider Directory

Locations

900 E 30th St
Ste 205
Austin, TX 78705
Phone (512) 236-1100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1790953271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 E 30TH ST STE 205",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787053378",
            "telephone_number": "512-236-1100",
            "fax_number": "512-236-1128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E 30TH ST STE 205",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78705",
            "telephone_number": "512-236-1100",
            "fax_number": "512-236-1128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELLY VELASQUEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-18",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "VELASQUEZ",
        "authorized_official_first_name": "NELLY",
        "authorized_official_middle_name": "DEL CARMEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-236-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L8547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165096201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.