Individual provider Active NPI

Jaimie C Juarez, PA-C, MHS

  • Physician Assistant
  • Modesto, CA
National Provider Identifier
1265826150
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
52392 Issued in CA
Practice address
1441 Florida Ave
Modesto, CA 95350-4404
Phone
(209) 578-1211
NPI assigned
Mar 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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 52392 CA Primary

Addresses

Primary practice location

1441 Florida Ave
Modesto, CA 95350-4404

Mailing address

1901 W Kettleman LN Ste 200
Lodi, CA 95242-4337
Phone (093) 348-5402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150518001269 CA Practitioner - Physician Assistant 0840510798 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinic Services of California Medical Group IncGroup PAC ID 7810209715, 65 clinicians

Practice addresses (Care Compare)

1235 W Vine St
Suite 20
Lodi, CA 95240-5144
Phone (209) 334-3411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.77 of 100Reported as apm
Quality
81.54
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Sep 29, 2024 Accepting new patients
Cep America - California CurrentSince Apr 1, 2015 Accepting new patients
Cep America-California CurrentSince Apr 1, 2015 Accepting new patients
Adventist Health Physicians Network CurrentSince Sep 29, 2024 Accepting new patients

Locations

1441 Florida Ave
Modesto, CA 95350
Phone (209) 214-7235

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1265826150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 W KETTLEMAN LN STE 200",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424337",
            "telephone_number": "093-348-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-578-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "JAIMIE",
        "middle_name": "C",
        "credential": "PA-C, MHS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "52392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.