Individual provider Active NPI

Camila Yepes, PA-C

  • Physician Assistant
  • Orlando, FL
National Provider Identifier
1093331985
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9112898 Issued in FL
Practice address
7605 Conroy Windermere Rd
Orlando, FL 32835-2646
Phone
(321) 244-6799
Fax
(401) 613-5915
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9112898 FL Primary

Addresses

Primary practice location

7605 Conroy Windermere Rd
Orlando, FL 32835-2646

Mailing address

2845 Pga Blvd
Palm Beach Gardens, FL 33410-2910
Phone (561) 693-0540

Other identifiers 1

IdentifierTypeStateIssuer
OU530OtherFLMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200824002706 FL Practitioner - Physician Assistant 0143647073 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Florida, PAGroup PAC ID 1153390414, 184 clinicians

Practice addresses (Care Compare)

14840 Tamiami TRL
North Port, FL 34287-2701
Phone (941) 564-1542

7605 Conroy Windermere Rd
Orlando, FL 32835-2646
Phone (321) 244-6799

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Water'S Edge Dermatology, LLC CurrentSince Aug 2, 2021 Accepting new patients
Naples Center for Dermatology & Riverchase Dermatology CurrentSince Jan 1, 2022 Accepting new patients

Locations

22411 US Highway 27
Lake Wales, FL 33859
Phone (863) 225-7295

6250 Lantana Rd
Ste 9
Lake Worth, FL 33463
Phone (561) 578-8100

3659 S Miami Ave
Ste 6008
Miami, FL 33133
Phone (305) 854-5432

1015 Crosspointe Dr
Naples, FL 34110
Phone (239) 596-9075

14840 Tamiami Trl
North Port, FL 34287
Phone (941) 564-1542

301 NE 19th Dr
Okeechobee, FL 34972
Phone (863) 357-0039

7605 Conroy Windermere Rd
Orlando, FL 32835
Phone (321) 244-6799

2845 Pga Blvd
Palm Beach Gardens, FL 33410
Phone (561) 693-0540

3107 13th St
Saint Cloud, FL 34769
Phone (321) 244-6755

4002 Sun City Center Blvd
Unit 102
Sun City Ctr, FL 33573
Phone (813) 634-1455

38162 Medical Center Ave
Zephyrhills, FL 33540
Phone (813) 782-2165

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cyepes@aquadermatology.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1093331985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 PGA BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102910",
            "telephone_number": "561-693-0540",
            "fax_number": "561-296-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7605 CONROY WINDERMERE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328352646",
            "telephone_number": "321-244-6799",
            "fax_number": "401-613-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEPES",
        "first_name": "CAMILA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "OU530",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.