Malcolm Jewell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2015-0026 Issued in NM

Practice address

Corner of Route N12 and N7
Fort Defiance, AZ 86504

Phone

(928) 729-8000

NPI assigned

May 6, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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.

• The Fort Defiance Indian Hospital Board, Incorporation

  dba Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1477876639

  TX

  Medicare reassignment NPD
• Usacs Community Emergency Services of Colorado, Inc.

  • Emergency Medicine Physician
  • Breckenridge, CO
  • NPI 1003549460
  NPD
• Usacs Community Emergency Services of Colorado, Inc.

  • Emergency Medicine Physician
  • Dacono, CO
  • NPI 1548895030
  NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Durango, CO
  • NPI 1235765074
  NPD
• Usacs of Colorado Inc

  • Emergency Medicine Physician
  • Lakewood, CO
  • NPI 1720614217
  NPD

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1487064838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "MALCOLM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-06",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2015-0026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Elizabeth Jacques, MPT
• Jacquelyn James, CRNA
• Lilia Janzen-Trotsyuk
• Gregory Jarrin, MD
• Michael R. Jarvis, D.O.
• Roanne Jimenez
• Kendall Rae John
• Mae Y John, MS CF SLP
• Illya Johnson-Hicklen, RCP
• Roberta S. Johnson-Seay, ARNP-C

• Physician Assistant in Fort Defiance, AZ
• Providers in Fort Defiance, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2022; 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.