Individual provider Active NPI

Mick Juarez, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Ashland, OR
National Provider Identifier
1205446978
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
DO2198390 Issued in OR
Practice address
850 Siskiyou Blvd Ste 7
Ashland, OR 97520-2125
Phone
(509) 432-3297
NPI assigned
Aug 6, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X DO2198390 OR Primary

Addresses

Primary practice location

850 Siskiyou Blvd Ste 7
Ashland, OR 97520-2125

Mailing address

850 Siskiyou Blvd Ste 7
Ashland, OR 97520-2125
Phone (509) 432-3297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240926002257 OR Practitioner - Osteopathic Manipulative Medicine 5698216976 Practice locations: Ashland, OR

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Rocky Vista University College of Osteopathic Med, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

850 Siskiyou Blvd
Suite 7
Ashland, OR 97520-2125
Phone (541) 482-0342

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO2198390ORMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osteopathic Integrative Medicine LLC Neuromusculoskeletal Medicine & Omm CurrentSince Jul 13, 2024 Accepting new patients

Locations

850 Siskiyou Blvd
Ste 7
Ashland, OR 97520
Phone (541) 482-0342

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1205446978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SISKIYOU BLVD STE 7",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202125",
            "telephone_number": "509-432-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 SISKIYOU BLVD STE 7",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202125",
            "telephone_number": "509-432-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "MICK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-06",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "OR",
            "license": "DO2198390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

Verify at the official NPI Registry.