Gisela Velez, M.D., LLC
Organization Active NPI Specialist · Ayer, MA
NPI 1962767541 · NPPES record last updated Jul 10, 2012
Key facts
- NPI
- 1962767541
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 210293 (MA)
- Legal business name
- GISELA VELEZ, M.D., LLC
- Practice address
- 190 Groton Rd
Suite 240
Ayer, MA 01432-1124 - Phone
- (978) 772-4000
- Fax
- (978) 772-3066
- NPI assigned
- Jul 10, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Gisela V Elez, M.D.
- Title
- President
- Phone
- (978) 772-4000
Practitioners 1
-
Gisela Velez, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131210000828 | MA | Part B Supplier - Clinic/Group Practice | 0345477733 |
Receives reassigned benefits from 1 practitioner Practice locations: Marlborough, MA; Worcester, MA |
National Provider Directory
Locations
2 Eastern Ave
Worcester, MA 01605
Phone (508) 552-0066
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 210293 | MA | Yes |
Addresses
Primary practice location
190 Groton Rd
Suite 240
Ayer, MA 01432-1124
Mailing address
190 Groton Rd
Suite 240
Ayer, MA 01432-1191
Phone (978) 772-4000
Other providers in Ayer, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.