Individual provider Active NPI

Cameron Mejia, PT, DPT, CSCS

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1558067884
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
32844 Issued in AZ
Practice address
4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418
Phone
(480) 503-2373
NPI assigned
Feb 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 32844 AZ Primary

Addresses

Primary practice location

4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418

Mailing address

2550 S San Tan Village Pkwy Apt 3082
Gilbert, AZ 85295-7886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230302001194 AZ Practitioner - Physical Therapist in Private Practice 6305219940 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32844AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
360 Physical Therapy LLC Physical Therapist CurrentSince Feb 13, 2023 Accepting new patients
360 Physical Therapy LLC Physical Therapist CurrentSince Feb 13, 2023 Accepting new patients
360 Physical Therapy, LLC Current Accepting new patients
360 Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224
Phone 4808211997116

1472 E Williams Field Rd
Ste 1
Gilbert, AZ 85295

10861 E Baseline Rd
Ste A105
Mesa, AZ 85209
Phone (520) 231-1360

4210 E Baseline Rd
Ste 106
Mesa, AZ 85206
Phone (480) 503-2373

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1558067884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 S SAN TAN VILLAGE PKWY APT 3082",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852957886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 E BASELINE RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064418",
            "telephone_number": "480-503-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIA",
        "first_name": "CAMERON",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "32844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.