Individual provider Active NPI

Ruth Yolanda Romero Velasco, MD

  • General Acute Care Hospital
  • Boston, MA
National Provider Identifier
1992158547
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
268008 Issued in MA
Practice address
2100 Dorchester Ave
Boston, MA 02124-5615
Phone
(617) 296-4000
NPI assigned
Jul 19, 2016
Last updated
Nov 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 268008 MA Primary
Internal Medicine Physician 207R00000X 86500 SC

Addresses

Primary practice location

2100 Dorchester Ave
Boston, MA 02124-5615

Mailing address

9 Huguenin Ave Apt 306
Charleston, SC 29403-7039
Phone (929) 257-9453

Other practice location 1

9330 Medical Plaza Dr
North Charleston, SC 29406-9104
Phone (843) 797-7000

Other identifiers 1

IdentifierTypeStateIssuer
0704492065OtherMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL OTHERURL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20211220000617 SC Practitioner - Internal Medicine 6305237728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (843) 782-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
86500SCMDInternal Medicine Physician
268008MAMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC Internal Medicine CurrentSince Oct 14, 2021 Accepting new patients
Trident Medical Center, LLC General Acute Care Hospital Past Accepting new patients

Locations

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

295 Midland Pkwy
Summerville, SC 29485
Phone (843) 554-6366

501 Robertson Blvd
Walterboro, SC 29488
Phone (843) 549-2000

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, 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": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1992158547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HUGUENIN AVE APT 306",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294037039",
            "telephone_number": "929-257-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-296-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9330 Medical Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294069104",
            "country_code": "US",
            "telephone_number": "843-797-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMERO VELASCO",
        "first_name": "RUTH",
        "middle_name": "YOLANDA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MA",
            "license": "268008",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "86500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0704492065",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OTHERURL",
            "affiliation": "N",
            "address_1": "9330 Medical Plaza Dr",
            "city": "North Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294069104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.