Edric Jason R. Caampued, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9115931 Issued in FL

Practice address

1859 Van Buren St
Hollywood, FL 33020-5127

Phone

(954) 930-9000

NPI assigned

Nov 2, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1083321624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15320 SW 49TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "33027",
            "telephone_number": "954-397-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 VAN BUREN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330205127",
            "telephone_number": "954-930-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N Federal Hwy Ste 601",
            "address_purpose": "LOCATION",
            "city": "Hallandale Beach",
            "state": "FL",
            "postal_code": "330092449",
            "country_code": "US",
            "telephone_number": "954-573-2195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAAMPUED",
        "first_name": "EDRIC JASON",
        "middle_name": "R.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9115931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Michele Byrd
• Benjamin Jay Byriel, DO
• C & H Medical Corp.
• C and M Behavioral LLC
• Sandra Maria Caamano
• Julie Lorraine Caballero, PTA
• Lizette Caballero, ARNP
• Niyer Jessel Caballero, LICSW
• Rebekah Caballero
• Yenisleidys Cabanes

• Medical Physician Assistant in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.