Maxine Amanda Velazquez

Key facts

NPI

1952863565

Entity type

Individual (NPI type 1)

Primary specialty

Student in an Organized Health Care Education/Training Program 390200000X

Practice address

995 Potrero Ave BLDG 80
San Francisco, CA 94110-2859

Phone

(415) 206-5252

NPI assigned

Apr 2, 2019

Sex

Female

Sole proprietor

Yes

Organizations & group practices 6

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.

• Southern California Permanente Medical Group Health Maintenance Organization · Baldwin Park, CA · NPI 1770515280
  Medicare reassignment Care Compare group NPD CA
• Southern California Permanente Medical Group Health Maintenance Organization · Riverside, CA · NPI 1316979834
  Care Compare group
• Southern California Permanente Medical Group Clinical Medical Laboratory · N Hollywood, CA · NPI 1891873303
  Care Compare group
• Southern California Permanente Medical Group Health Maintenance Organization · Woodland Hills, CA · NPI 1952333478
  Care Compare group
• Southern California Permanente Medical Group Health Maintenance Organization · Santa Clarita, CA · NPI 1316409410
  NPD
• Southern California Permanente Medical Group Health Maintenance Organization · Panorama City, CA · NPI 1407888928
  NPD

Hospital & facility affiliations 1

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

• Kaiser Foundation Hospitals General Acute Care Hospital · Panorama City, CA · NPI 1376698043
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Family Practice

Education

University of California, Geffen School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical Group (11,250 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital - Panorama City Hospital · Panorama City, CA · CCN 050137

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Locations

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 26, 2023.

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1952863565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 POTRERO AVE BLDG 80",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102859",
            "telephone_number": "415-206-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "995 POTRERO AVE BLDG 80",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102859",
            "telephone_number": "415-206-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "MAXINE",
        "middle_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Francisco, CA

• Fernando Velayos, MD
• Ana Isabel Velazquez, MD MSC
• Andy Dean Velazquez
• Edgar Josue Velazquez
• Erica Velazquez
• Ruben Velazquez, LMFT156397
• Angel Velez Gutierrez
• Blanca Velez, M.D.
• Elissa A Velez, BBS
• Liberty Star Velez

All providers in San Francisco, CA · Student in an Organized Health Care Education/Training Program in California