Individual provider Active NPI

Allyson Marie Campuzano, PA-C

  • Physician Assistant
  • Miami, FL
National Provider Identifier
1407487481
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9112923 Issued in FL
Practice address
15955 SW 96TH St Ste 401
Miami, FL 33196-1273
Phone
(786) 467-3430
Fax
(786) 533-9695
NPI assigned
Jan 29, 2020
Last updated
Feb 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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 9112923 FL Primary

Addresses

Primary practice location

15955 SW 96TH St Ste 401
Miami, FL 33196-1273

Mailing address

PO Box 100905
Atlanta, GA 30384-1273
Phone (786) 594-6880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200313000084 FL Practitioner - Physician Assistant 6002244670 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5000 University Dr
Coral Gables, FL 33146-2008
Phone (786) 308-3401

6200 SW 73 St
South Miami, FL 33143-4679
Phone (786) 662-4000

9555 SW 162 Ave
West Kendall Baptist Hospital
Miami, FL 33196-6408
Phone (786) 467-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.58 of 100Reported as group
Quality
72.08
Promoting interoperability
99
Improvement activities
40
Cost
74.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9112923FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Orthopedics, LLC CurrentSince Feb 13, 2020 Accepting new patients
Baptist Health Medical Group Orthopedics, LLC CurrentSince Feb 13, 2020 Accepting new patients

Locations

15955 SW 96th St
Ste 401
Miami, FL 33196
Phone (786) 467-3430

8940 N Kendall Dr
Ste 602E
Miami, FL 33176
Phone (305) 598-3227

6200 SW 72nd St
Ste 602
South Miami, FL 33143
Phone (786) 662-0600

6200 SW 73rd St
South Miami, FL 33143
Phone (305) 661-4611

Interoperability endpoints

  • Direct secure messaging: allycamp@cerner.directbaptisthealth.com

Organizations & group practices 2

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 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": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1407487481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100905",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841273",
            "telephone_number": "786-594-6880",
            "fax_number": "786-533-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15955 SW 96TH ST STE 401",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331961273",
            "telephone_number": "786-467-3430",
            "fax_number": "786-533-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPUZANO",
        "first_name": "ALLYSON",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9112923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.