Kei Julia Velazquez, CNM is a medicare enrolled "Midwife" in Fort Bragg, California. Her current practice location is
855 Sequoia Cir, Fort Bragg, California. You can reach out to her office (for appointments etc.) via phone at
(707) 964-1251.
Kei Julia Velazquez is licensed to practice in California (license number 1448) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1760581631.
Provider's Profile
| Full Name | Kei Julia Velazquez |
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| Gender | Female |
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| Speciality | Midwife |
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| Location | 855 Sequoia Cir, Fort Bragg, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1760581631
- Provider Enumeration Date: 09/21/2006
- Last Update Date: 12/30/2011
Medicare PECOS Information:
- PECOS PAC ID: 7517140544
- Enrollment ID: I20110329000041
Medical Identifiers
Medical identifiers for Kei Julia Velazquez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760581631 | NPI | - | NPPES |
| 11789 | Other | CA | NURSE PRACTITIONER |
| 1448 | Other | CA | NURSE MIDWIFE |
| CMM71141F | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | 11789 (California) | Secondary |
| 176B00000X | Midwife | 1448 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kei Julia Velazquez allows following entities to bill medicare on her behalf.
| Entity Name | Mendocino Coast Clinics, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609595404
PECOS PAC ID: 5991619157
Enrollment ID: O20050512001033 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kei Julia Velazquez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kei Julia Velazquez, CNM
205 South St,
Fort Bragg, CA 95437-5540
Ph: (707) 964-1251 | Kei Julia Velazquez, CNM
855 Sequoia Cir,
Fort Bragg, CA 95437-5466
Ph: (707) 964-1251 |
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