Active NPI
Nelly Velasquez MD PA
- Family Medicine Physician
- Austin, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- L8547
- 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
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.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 165096201 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1028105 | Nelly Velasquez MD PA | Certificate of waiver | Jul 19, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Medicine Physician
- Austin, TX
- NPI 1619955218
Family Medicine, TX
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.