Individual provider Active NPI

Gretchen M Velasco, M.D.

  • Obstetrics & Gynecology Physician
  • Mission, TX
National Provider Identifier
1811973480
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
L2725 Issued in TX
Practice address
910 S Bryan Rd
Suite 204
Mission, TX 78572-6658
Phone
(956) 581-3900
Fax
(956) 581-3904
NPI assigned
Dec 15, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X L2725 TX Primary

Addresses

Primary practice location

910 S Bryan Rd
Suite 204
Mission, TX 78572-6658

Mailing address

PO Box 1748
Mission, TX 78573-0030
Phone (956) 581-3900

Other identifiers 1

IdentifierTypeStateIssuer
MEDICAIDMedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040731000270 TX Practitioner - Obstetrics/Gynecology 5890765275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Ponce School of Medicine, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

910 S Bryan Rd
Suite 204W
Mission, TX 78572-6659
Phone (956) 581-3900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L2725TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gretchen M Velasco, Mdpa Obstetrics & Gynecology CurrentSince Jan 1, 2006 Accepting new patients

Locations

910 S Bryan Rd
Ste 204W
Mission, TX 78572
Phone (956) 581-3900

Interoperability endpoints

  • Direct secure messaging: gretchenvelasco-mmgmv@direct.medalliesmail.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811973480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1748",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785730030",
            "telephone_number": "956-581-3900",
            "fax_number": "956-581-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S BRYAN RD",
            "address_2": "SUITE 204",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726658",
            "telephone_number": "956-581-3900",
            "fax_number": "956-581-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "GRETCHEN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "L2725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MEDICAID",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.