MRS. MYRNA VELAZQUEZ FNP
NPI 1083902654
Nurse Practitioner - Family in Clarksville, IN
About Mrs. Myrna Velazquez Fnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. MYRNA VELAZQUEZ FNP (NPI 1083902654) is an individual family provider in Clarksville, Indiana, licensed in Illinois (209008817) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mrs. Myrna Velazquez Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Myrna Velazquez reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Demotte, IN 46310
- Reassigned Medicare billing, Indiana enrollment
- 134 clinicians in this Medicare group
Sparks, MD 21152
- Reassigned Medicare billing, Indiana enrollment
- 84 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 47129 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Myrna Velazquez's NPI number?
The NPI number for Myrna Velazquez is 1083902654. It was assigned to this individual provider in the NPPES registry on July 18, 2011. The provider is also known as Ms. Myrna Montanez Rn.
Where is Myrna Velazquez located?
Myrna Velazquez practices at 101 Potters Ln, Clarksville, IN 47129. The listed phone number is (443) 383-9300.
What is Myrna Velazquez's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Myrna Velazquez enrolled in Medicare?
Yes. Myrna Velazquez is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Myrna Velazquez's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Myrna Velazquez reassigns Medicare benefits to 2 organizations: Northshore Health Centers, Inc. (Demotte, IN) and Consonant Healing Associates Of De LLC (Sparks, MD). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Myrna Velazquez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Myrna Velazquez was last updated on October 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Myrna Velazquez, FNP · NPI 1083902654
Family physician in Clarksville, Indiana. Individual provider, active in the CMS NPPES registry since July 18, 2011.
## Identity
- **NPI:** 1083902654 (Entity type: Individual)
- **Enumerated:** July 18, 2011
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 209008817 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 101 POTTERS LN, Clarksville, IN 47129-1017
- **Phone:** (443) 383-9300 · **Fax:** (855) 866-8710
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Northshore Health Centers, Inc. (NPI 1295498947, Demotte, IN); Consonant Healing Associates Of De LLC (NPI 1669099321, Sparks, MD) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 20, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1083902654) · Data from the CMS NPPES public registry.