Paul Ace Jim III, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-22382 Issued in AZ

Practice address

777 W Southern Ave
Mesa, AZ 85210-5008

Phone

(602) 279-5262

Fax

(541) 504-1195

NPI assigned

Sep 28, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Native HealthGroup PAC ID 4385738418, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: paul.jim.p1@direct.nachci.nextgenshare.com

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.

• Native Health

  dba Native American Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1740462761
  Medicare reassignment Care Compare group NPD
• Native Health

  dba Native American Community Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
  • NPI 1780121244
  NPD
• Native Health

  dba Native American Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1982830410
  NPD
• Native Health

  dba Native American Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Mesa, AZ
  • NPI 1336654383
  NPD (past)

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1154791580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 W SOUTHERN AVE BLDG E",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105008",
            "telephone_number": "602-279-5262",
            "fax_number": "541-504-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105008",
            "telephone_number": "602-279-5262",
            "fax_number": "541-504-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIM",
        "first_name": "PAUL",
        "middle_name": "ACE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-28",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "17-04-09",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-22382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jfox II LLC (Red Mountain Rehab)
• Lokesh Kumar Jha, MD
• Tae Hoon Ji, L.AC
• Mary Jiaocma
• Moh'D Jibreel, MD
• Jonathan Jimenez Flores, DPT
• Jose Manuel Jimenez-Cintron, MD
• Amy Michelle Jimenez
• Ashley Jimenez, SLPA
• Claudette Jimenez

• Clinical Social Worker in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.