NPIMap

Individual provider Active NPI

Juvy Escalante, PA

  • Physician Assistant
  • Kingman, AZ
National Provider Identifier
1053650416
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10524 Issued in AZ
Practice address
3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone
(928) 757-2101
NPI assigned
Feb 5, 2013
Last updated
Nov 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10524 AZ Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X PA 21502 CA

Addresses

Primary practice location

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619

Mailing address

PO Box 4325
Oceanside, CA 92052-4325
Phone (760) 473-0444

Other practice location 1

204 S Santa Fe Ave
Vista, CA 92084-6002
Phone (760) 473-0444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140222000105 CA Practitioner - Physician Assistant 2961632823 Reassigns benefits to 2 organizations
I20240911003661 AZ Practitioner - Physician Assistant 2961632823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group IncGroup PAC ID 2961314265, 85 clinicians
Fountain Valley Group Services PCGroup PAC ID 9931427382, 16 clinicians

Practice addresses (Care Compare)

101 Civic Ctr LN
Lake Havasu City, AZ 86403-5607
Phone (928) 855-8185

47111 Monroe St
Indio, CA 92201-6739
Phone (760) 347-6191

5330 S Hwy 95
Fort Mohave, AZ 86426-9225
Phone (928) 788-7077

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 21502CAMDAddiction Medicine (Family Medicine) Physician
10524AZMDPhysical Therapist
21502CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Inc CurrentSince Jul 28, 2024 Accepting new patients
Providence Facey Medical Foundation CurrentSince Oct 22, 2019 Accepting new patients
PHC-Fort Mohave Inc Past Accepting new patients

Locations

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

19950 Rinaldi St
Ste 103
Porter Ranch, CA 91326
Phone (818) 403-2400

Interoperability endpoints

  • Direct secure messaging: iyk2919@yourcarecommunity.org

Organizations & group practices 5

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 3

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": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1053650416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4325",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920524325",
            "telephone_number": "760-473-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 S Santa Fe Ave",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920846002",
            "country_code": "US",
            "telephone_number": "760-473-0444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESCALANTE",
        "first_name": "JUVY",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10524",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "PA 21502",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.