Individual provider Active NPI

Jose F Mahiquez, PA

  • Physician Assistant
  • Dunn, NC
National Provider Identifier
1528045234
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102070 Issued in NC
Practice address
605 W Cumberland St
Dunn, NC 28334-4823
Phone
(910) 891-1391
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 102070 NC Primary

Addresses

Primary practice location

605 W Cumberland St
Dunn, NC 28334-4823

Mailing address

P O Box 960226
Oklahoma City, OK 73196-0001
Phone (877) 485-4474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040817001446 NC Practitioner - Physician Assistant 3870566870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical Branch at Galveston, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med First Immediate Care and Family Practice PAGroup PAC ID 0446332720, 94 clinicians

Practice addresses (Care Compare)

388 Venture Dr
Suite 1
Smithfield, NC 27577-4775
Phone (919) 938-0811

609 Richlands Hwy 6
Jacksonville, NC 28540-3606
Phone (910) 455-7888

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bestpractices of North Carolina PC Past Accepting new patients
Med Fast, P. C. Physician Assistant PastSince Feb 8, 2003 Accepting new patients
Shoreview Medical Associates, PLLC Past Accepting new patients
Sterling Emergency Services of the Southeast, Inc Physician Assistant Past Accepting new patients
Good Hope Hospital, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jose.mahiquez.1@1905.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528045234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 960226",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960001",
            "telephone_number": "877-485-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 W CUMBERLAND ST",
            "city": "DUNN",
            "state": "NC",
            "postal_code": "283344823",
            "telephone_number": "910-891-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHIQUEZ",
        "first_name": "JOSE",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunn, NC

Sources for this page

Verify at the official NPI Registry.