Individual provider Active NPI

Teresa K Velez, ARNP

  • Family Nurse Practitioner
  • Palm Coast, FL
National Provider Identifier
1871880732
Registry record updated Sep 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9226068 Issued in FL
Practice address
42 Seaton Valley Path
Palm Coast, FL 32164-5365
Phone
(386) 453-7268
NPI assigned
Jun 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9226068 FL Primary
Registered Nurse First Assistant 163WR0006X ARNP 9226068 FL

Addresses

Primary practice location

42 Seaton Valley Path
Palm Coast, FL 32164-5365

Mailing address

42 Seaton Valley Path
Palm Coast, FL 32164-5365
Phone (386) 453-7268

Other identifiers 1

IdentifierTypeStateIssuer
004380200MedicaidFL

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
I20131126001143 FL Practitioner - Nurse Practitioner 4688800428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

42 Seaton Valley Path
Palm Coast, FL 32164-5365
Phone (386) 453-7268

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9226068FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Daniel Potts MD PLLC CurrentSince Dec 5, 2015 Accepting new patients
Tkvelez Surgical Assisting, Inc. Registered Nurse First Assistant CurrentSince Apr 21, 2018 Accepting new patients

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 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": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441584000000",
    "number": "1871880732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 SEATON VALLEY PATH",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645365",
            "telephone_number": "386-453-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 SEATON VALLEY PATH",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645365",
            "telephone_number": "386-453-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELEZ",
        "first_name": "TERESA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2015-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9226068",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "FL",
            "license": "ARNP 9226068",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004380200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.