Individual provider Active NPI

Jeannette Velazquez-Gomez

  • Family Nurse Practitioner
  • Wesley Chapel, FL
National Provider Identifier
1851860670
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11000260 Issued in FL
Practice address
31236 Bridgegate Dr
Wesley Chapel, FL 33545-8219
Phone
(321) 537-7636
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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 11000260 FL Primary

Addresses

Primary practice location

31236 Bridgegate Dr
Wesley Chapel, FL 33545-8219

Mailing address

31236 Bridgegate Dr
Wesley Chapel, FL 33545-8219
Phone (321) 537-7636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190522000193 FL Practitioner - Nurse Practitioner 8527301159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

Wesley Chapel, FL 33545
Phone (813) 524-7122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11000260FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Portal MD Inc CurrentSince Apr 1, 2019 Accepting new patients
JV Mobile Care CurrentSince Apr 1, 2022 Accepting new patients

Locations

13150 Vail Ridge Dr
Riverview, FL 33579
Phone (813) 374-8883

Organizations & group practices 2

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

Hospital & facility affiliations 5

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": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1851860670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31236 BRIDGEGATE DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335458219",
            "telephone_number": "321-537-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31236 BRIDGEGATE DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335458219",
            "telephone_number": "321-537-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ-GOMEZ",
        "first_name": "JEANNETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11000260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

Verify at the official NPI Registry.