Active NPI
Dennis M. Juarros, PHYSICIAN ASSISTANT
- Physician Assistant
- Los Alamos, NM
National Provider Identifier
1114058187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 96-PA 20
- Practice address
- Los Alamos National Lab
Occupational Medicine, Ms D421
Los Alamos, NM 87545-0001 - Phone
- (505) 667-7890
- NPI assigned
- Mar 8, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 96-PA 20 | NM | Primary |
Addresses
Primary practice location
Los Alamos National Lab
Occupational Medicine, Ms D421
Los Alamos, NM 87545-0001
Mailing address
751 Coyote Ridge Rd
Santa Fe, NM 87507-9630
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 96-PA 20 | NM | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114058187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "751 COYOTE RIDGE RD",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875079630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LOS ALAMOS NATIONAL LAB",
"address_2": "OCCUPATIONAL MEDICINE, MS D421",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875450001",
"telephone_number": "505-667-7890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUARROS",
"first_name": "DENNIS",
"middle_name": "M.",
"name_prefix": "Mr.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NM",
"license": "96-PA 20",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.