Haley Camacho, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601010101 Issued in MI

Practice address

5701 Bow Pointe Dr Ste 100
Clarkston, MI 48346-3199

Phone

(248) 625-2621

Fax

(248) 625-2622

NPI assigned

Nov 25, 2020

Last updated

Dec 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Haley Durrant Former name

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: haley.camacho.1@3928.direct.athenahealth.com

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.

• McLaren Community Based Primary Care Group

  • Physical Medicine & Rehabilitation Physician
  • Flint, MI
  • NPI 1750241816
  Medicare reassignment NPD
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment NPD
• McLaren Community Based Primary Care Group

  • Physical Therapist
  • Clarkston, MI
  • NPI 1770448920
  NPD
• Michigan Healthcare Professionals PC

  dba Urology Specialist of Michigan

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1386248763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 BOW POINTE DR STE 100",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463199",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5625 Water Tower Pl Ste 300",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483462674",
            "country_code": "US",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5625 Water Tower Pl Ste 200",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483462674",
            "country_code": "US",
            "telephone_number": "248-625-2621",
            "fax_number": "248-625-2622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "HALEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601010101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "DURRANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Cabe, FNP
• Ricardo Q. Cabrera, M.D.
• Jennifer Ann Callender-Wright, OTR/L
• Alexander Calvert, LMSW
• Iomar A Camacho-Alvarez, PA-C
• Camela R. Ayoub LLC
• Christina L. Campbell, D.O.
• Hannah Mackenzie Campbell
• Melissa Campbell, DPT
• Sally Anne Campbell

• Medical Physician Assistant in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.