Individual provider Active NPI

Juan Felipe Prieto, PA-C, ATC

  • Physician Assistant
  • Tucson, AZ
National Provider Identifier
1245471663
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6278 Issued in AZ
Practice address
5301 E Grant Rd
Orthopaedic BLDG, 1St Floor
Tucson, AZ 85712
Phone
(520) 784-6200
Fax
(520) 784-6109
NPI assigned
Mar 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 1353 AZ
Surgical Physician Assistant 363AS0400X 6278 AZ
Physician Assistant 363A00000X 6278 AZ Primary

Addresses

Primary practice location

5301 E Grant Rd
Orthopaedic BLDG, 1St Floor
Tucson, AZ 85712

Mailing address

11710 N Edi PL
Tucson, AZ 85737-9571

Other identifiers 1

IdentifierTypeStateIssuer
154038MedicaidAZ

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
I20160127002743 AZ Practitioner - Physician Assistant 6002119831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tucson Orthopaedic Institute Professional CorporationGroup PAC ID 5799671905, 108 clinicians

Practice addresses (Care Compare)

6320 N la Cholla Blvd
Suite 200
Tucson, AZ 85741-3549
Phone (520) 382-8200

Hospital & facility affiliations

  • Northwest Medical Center Hospital, Tucson, AZ, CCN 030085

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6278AZMDPhysical Therapist
1353AZMDAthletic Trainer

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": "1236988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1245471663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 N EDI PL",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857379571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E GRANT RD",
            "address_2": "ORTHOPAEDIC BLDG, 1ST FLOOR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85712",
            "telephone_number": "520-784-6200",
            "fax_number": "520-784-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIETO",
        "first_name": "JUAN",
        "middle_name": "FELIPE",
        "name_prefix": "Mr.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-14",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "1353",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "6278",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154038",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.