Individual provider Active NPI

Juliana Del Valle Camejo, PA

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1194566414
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10401 Issued in AZ
Practice address
515 W Buckeye Rd Ste 104
Phoenix, AZ 85003-3699
Phone
(602) 257-8280
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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 10401 AZ Primary

Addresses

Primary practice location

515 W Buckeye Rd Ste 104
Phoenix, AZ 85003-3699

Mailing address

5454 Newcastle St Apt 1104
Houston, TX 77081-2260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250723000724 AZ Practitioner - Physician Assistant 7911413257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Doctors of Arizona PLLCGroup PAC ID 3870835044, 11 clinicians

Practice addresses (Care Compare)

515 W Buckeye Rd
Suite 104
Phoenix, AZ 85003-3699
Phone (602) 257-8280

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10401AZMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Warren H Heller MD PastSince Jun 9, 2024 Accepting new patients

Organizations & group practices 2

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": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1194566414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 NEWCASTLE ST APT 1104",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770812260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W BUCKEYE RD STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850033699",
            "telephone_number": "602-257-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMEJO",
        "first_name": "JULIANA",
        "middle_name": "DEL VALLE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.