Timothy J. Camasta, PAC

Primary specialty

Brain Injury Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P0301X

License

PA2353 Issued in CO

Practice address

7092 Harr Ave BLDG 6492
Fort Carson, CO 80902-2190

Phone

(719) 524-5217

Fax

(719) 526-3088

NPI assigned

Mar 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1104885615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7092 HARR AVE BLDG 6492",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809022190",
            "telephone_number": "719-524-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7092 HARR AVE BLDG 6492",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809022190",
            "telephone_number": "719-524-5217",
            "fax_number": "719-526-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMASTA",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12294",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2353",
            "primary": false
        },
        {
            "code": "2084P0301X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Brain Injury Medicine",
            "state": "CO",
            "license": "PA2353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Ruth Cacho-Mohr, DDS
• Amanda Marie Cain, MS, RD
• Arthur B Cajigal, D.O.
• James Boyd Calcut
• Andrew Callahan, D.M.D.
• Megan Jo Cameron, DVM
• Benjamin Chad Campbell, PHARMD
• Heather L Campbell, PHD
• Jonathan Michael Campbell, MD
• Koko Camita Cantrell, CRNA

• Brain Injury Medicine (Psychiatry & Neurology) Physician in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Brain Injury Medicine (Psychiatry & Neurology) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.