ROBERTO VELAZQUEZ
NPI 1356904734
Student in an Organized Health Care Education/Training Program in Warren, MI

Active since April 21, 2019Opted out of Medicare · through Jul 15, 2027
11900 E 12 MILE RD STE 210, WARREN, MI 48093(586) 582-7102 Get Directions Write a Review

NPPES record last updated: April 21, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Roberto Velazquez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROBERTO VELAZQUEZ (NPI 1356904734) is an individual student in an organized health care education/training program in Warren, Michigan and active in the NPI registry since April 2019. He has opted out of Medicare through July 15, 2027.

NPPES Registry Identity

NPI1356904734
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameROBERTO VELAZQUEZ
Location Address11900 E 12 MILE RD STE 210Warren, MI 48093-3490
Mailing Address101 Woodland AveSan Francisco, CA 94117-3862 · (775) 527-2340
Sole ProprietorNo
Enumeration DateApril 21, 2019
NPI 1356904734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

11900 E 12 MILE RD STE 210, Warren, MI 48093

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Roberto Velazquez has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 15, 2025 through July 15, 2027.

Opt-Out Effective DateJuly 15, 2025
Opt-Out In Effect ThroughJuly 15, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
11900 E 12 MILE RD STE 210
WARREN, MI 48093
Student in an Organized Health Care Education/Training Program
11900 E 12 MILE RD STE 210
WARREN, MI 48093
Student in an Organized Health Care Education/Training Program
11900 E 12 MILE RD STE 210
WARREN, MI 48093

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 Roberto Velazquez's NPI number?

The NPI number for Roberto Velazquez is 1356904734. It was assigned to this individual provider in the NPPES registry on April 21, 2019.

Where is Roberto Velazquez located?

Roberto Velazquez practices at 11900 E 12 Mile Rd Ste 210, Warren, MI 48093. The listed phone number is (586) 582-7102.

What is Roberto Velazquez's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Roberto Velazquez enrolled in Medicare?

No. Roberto Velazquez has opted out of Medicare through July 15, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Roberto Velazquez was last updated on April 21, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.