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Jose Pinlac Velasco

Family Medicine

Allopathic & Osteopathic Physicians

737 E Sevier Ave, Kingsport, TN 37660-4912

PECOS Enrollment

This provider is enrolled in PECOS as JOSE VELASCO.

Based on the most recent information from CMS, provider Jose Pinlac Velasco is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1861496390
Provider Type
Individual
Full Name
Velasco, Jose Pinlac
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
6/13/2005
Last Updated
1/3/2023

Contact Information

Practice Location

737 E Sevier Ave, Kingsport, TN 37660-4912

(423) 246-7922

(423) 246-4248

Mailing Location

PO Box 850, Rogersville, TN 37857-0850

(423) 921-6975

(423) 921-6920

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 26079 Tennessee

Provider Identifiers

ID	Description	Issuer
ID 4057104	Description Other	Issuer BCBST
ID 3087701	Description Medicaid	Issuer Unlisted Tennessee

Jose Pinlac Velasco

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Mclain, Scott D

Miller, Jerry

Harris, Erin Elizabeth

Blue Ridge Medical Management Corporation

Poortenga, Cynthia L

Vaughn, Jeffrey

Barakam, Neha

Delwadia, Andy

Fore, Edward Johnson

Brummel, Mark