Shelley L Velickoff, A.N.P.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

71011005A Issued in IN

Practice address

124 Sagamore Pkwy W.
West Lafayette, IN 47906

Phone

(765) 463-6722

Fax

(765) 463-0905

NPI assigned

Sep 10, 2012

Last updated

Dec 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Randall Dermatology, PCGroup PAC ID 3678675329, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.65 of 100Reported as group

Quality

91.4

Improvement activities

40

Cost

73.63

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Randall Dermatology, PC

  • Dermatology Physician
  • West Lafayette Bra, IN
  • NPI 1245340488
  Medicare reassignment Care Compare group NPD
• Albert C. Lee, M.D., P.C.

  dba Indiana Neurology Specialty Care

  • Neurology Physician
  • Lafayette, IN
  • NPI 1013047042
  NPD (past)

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1811246531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SAGAMORE PKWY W.",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "47906",
            "telephone_number": "765-463-6722",
            "fax_number": "765-463-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SAGAMORE PKWY W.",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "47906",
            "telephone_number": "765-463-6722",
            "fax_number": "765-463-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELICKOFF",
        "first_name": "SHELLEY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "A.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60277759",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "71011005A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanarsdel Family Dental, LLC (Klondike Dental Care)
• Baileigh E Vanwanzeele, OTR/L
• McKenzie Vanyek
• Casey Rose Vasilak, ATC/L
• Robert M Vazquez, DPT
• Riya Verma
• Zoe Vessels
• Jessie Villarreal, LPN
• Craig Alan Voll Jr., ATC, PT
• Marion Sides Vruggink

• Dermatology Physician in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.