Active NPI
Marc T Campos, PA-C
- Medical Physician Assistant
- Marion, IN
National Provider Identifier
1336589241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 4367
- Practice address
- 1103 N Baldwin Avenue
Marion, IN 46952-2536 - Phone
- (765) 660-7480
- Fax
- (765) 382-4495
- NPI assigned
- Jun 25, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | IN | ||
| Medical Physician Assistant | 363AM0700X | 4367 | CT | Primary |
Addresses
Primary practice location
1103 N Baldwin Avenue
Marion, IN 46952-2536
Mailing address
330 N Wabash
G20
Marion, IN 46952-2600
Phone (765) 660-7600
Other practice location 1
326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331
Other practice location 2
12 Lathrop Rd
Plainfield, CT 06374-2061
Phone (860) 457-9191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00001216651 | Other | IN | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 97.8 of 100
- Quality
- 90
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.43
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William W Backus Hospital | Current | Accepting new patients | |
| Danville Family Eye Care LLC | Past | Accepting new patients |
Locations
326 Washington St
Norwich, CT 06360
Phone (860) 701-0140
Interoperability endpoints
- marc.campos@xdr.hhchealthdirect.org
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1467517235
-
- Family Medicine Physician
- Putnam, CT
- NPI 1376813972
-
- Emergency Medicine Physician
- Putnam, CT
- NPI 1447231865
-
- Psychiatric Hospital Unit
- Norwich, CT
- NPI 1730243536
-
- Optometrist
- Danville, IN
- NPI 1710353412
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1467517235
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1639135718
-
- Psychiatric Hospital Unit
- Norwich, CT
- NPI 1730243536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561939200000",
"number": "1336589241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 N WABASH",
"address_2": "G20",
"city": "MARION",
"state": "IN",
"postal_code": "469522600",
"telephone_number": "765-660-7600",
"fax_number": "765-651-7313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1103 N BALDWIN AVENUE",
"city": "MARION",
"state": "IN",
"postal_code": "469522536",
"telephone_number": "765-660-7480",
"fax_number": "765-382-4495"
}
],
"practiceLocations": [
{
"address_1": "326 Washington St",
"address_purpose": "LOCATION",
"city": "Norwich",
"state": "CT",
"postal_code": "063602740",
"country_code": "US",
"telephone_number": "860-889-8331",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "12 Lathrop Rd",
"address_purpose": "LOCATION",
"city": "Plainfield",
"state": "CT",
"postal_code": "063742061",
"country_code": "US",
"telephone_number": "860-457-9191",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CAMPOS",
"first_name": "MARC",
"middle_name": "T",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-25",
"last_updated": "2019-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IN",
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CT",
"license": "4367",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "00001216651",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; 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.