Individual provider Active NPI

Eddiee Velasquez

  • Family Nurse Practitioner
  • Towson, MD
National Provider Identifier
1811740897
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R257017 Issued in MD
Practice address
913 Southerly Rd
Towson, MD 21204-2611
Phone
(302) 396-0513
NPI assigned
Apr 9, 2024
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R257017 MD Primary

Addresses

Primary practice location

913 Southerly Rd
Towson, MD 21204-2611

Mailing address

913 Southerly Rd Apt 462
Towson, MD 21204-2647
Phone (302) 396-0513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240802001535 MD Practitioner - Nurse Practitioner 1052858438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umms Ambulatory Care LLCGroup PAC ID 8426461427, 53 clinicians

Practice addresses (Care Compare)

1730 Merritt Blvd
Dundalk, MD 21222-3212
Phone (410) 650-4730

600 E Belvedere Ave
Suite a
Baltimore, MD 21212-3773
Phone (410) 296-0018

711 W 40TH St
Suite 173
Baltimore, MD 21211-2147
Phone (443) 961-1221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Umms Ambulatory Care LLC CurrentSince Jul 15, 2024 Accepting new patients
Umms Ambulatory Care LLC Current Accepting new patients
Umms Ambulatory Care LLC CurrentSince Jul 15, 2024 Accepting new patients

Locations

8 Denton Plz
Denton, MD 21629
Phone (443) 606-2300

1730 Merritt Blvd
Dundalk, MD 21222
Phone (410) 282-2756

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

Interoperability endpoints

  • Direct secure messaging: evelasquez1233670@direct.umm.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1811740897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 SOUTHERLY RD APT 462",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042647",
            "telephone_number": "302-396-0513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 SOUTHERLY RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042611",
            "telephone_number": "302-396-0513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "EDDIEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R257017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.