Individual provider Active NPI

Jeniffer Diane Machuca, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1376209833
Registry record updated Apr 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9965 Issued in AZ
Practice address
3929 E Bell Rd
Phoenix, AZ 85032-2112
Phone
(541) 789-7000
NPI assigned
Nov 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 9965 AZ Primary

Addresses

Primary practice location

3929 E Bell Rd
Phoenix, AZ 85032-2112

Mailing address

2005 S Sertoma Ave
Sioux Falls, SD 57106-4560
Phone (480) 399-8020

Other practice location 1

18701 N 67th Ave
Glendale, AZ 85308-7100
Phone (623) 561-1000

Other practice location 2

7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone (480) 882-4000

Other practice location 3

2000 W Bethany Home Rd
Phoenix, AZ 85015-2443
Phone (602) 249-0212

Other names 1

  • Jeniffer Diane Aguilar Former name

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
I20240111001975 AZ Practitioner - Physician Assistant 9436541901 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of Hope Medical Group of Arizona LLCGroup PAC ID 2264593474, 159 clinicians
Honorhealth AmbulatoryGroup PAC ID 5991603110, 630 clinicians
Arizona Acute Medical Services 1 PCGroup PAC ID 6204113970, 49 clinicians

Practice addresses (Care Compare)

14200 W Celebrate Life Way
Goodyear, AZ 85338-3007
Phone (623) 207-3000

3198 N Windsong Dr
Prescott Valley, AZ 86314-2239
Phone (623) 683-7555

3929 E Bell Rd
Phoenix, AZ 85032-2112
Phone (602) 923-5000

7400 E Osborn Rd
Scottsdale, AZ 85251-6432
Phone (480) 882-6700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9965AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Honorhealth Ambulatory CurrentSince Feb 19, 2024 Accepting new patients
Honorhealth Ambulatory CurrentSince Feb 19, 2024 Accepting new patients
Arizona Post-Acute Medical Services 1 PC Single Specialty Past Accepting new patients

Locations

3198 N Windsong Dr
Prescott Vly, AZ 86314
Phone (480) 596-1110

10510 N 92nd St
Ste 200
Scottsdale, AZ 85258
Phone (480) 323-1250

7400 E Osborn Rd
Scottsdale, AZ 85251
Phone (480) 481-4000

7351 E Osborn Rd
Ste 200B
Scottsdale, AZ 85251
Phone (480) 882-5730

Interoperability endpoints

  • Direct secure messaging: jmachuca182986@cityofhope.direct-ci.com

Organizations & group practices 6

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 4

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": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712361600000",
    "number": "1376209833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 S SERTOMA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571064560",
            "telephone_number": "480-399-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 E BELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322112",
            "telephone_number": "541-789-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18701 N 67th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853087100",
            "country_code": "US",
            "telephone_number": "623-561-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7400 E Osborn Rd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852516432",
            "country_code": "US",
            "telephone_number": "480-882-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 W Bethany Home Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850152443",
            "country_code": "US",
            "telephone_number": "602-249-0212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACHUCA",
        "first_name": "JENIFFER",
        "middle_name": "DIANE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2024-04-06",
        "certification_date": "2024-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENIFFER",
            "last_name": "AGUILAR",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.