Jose Antonio Pesqueira

Primary specialty

ContractorTaxonomy code 171W00000X

License

7784629 Issued in AZ

Practice address

800 E Baffert Dr Apt W101
Nogales, AZ 85621-4210

Phone

(520) 980-2320

NPI assigned

Apr 13, 2018

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1578050787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "994 S HARRISON RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857486608",
            "telephone_number": "520-721-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E BAFFERT DR APT W101",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856214210",
            "telephone_number": "520-980-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESQUEIRA",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Contractor",
            "state": "AZ",
            "license": "7784629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorena Paredes, ACNPC-AG
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• Susana Perez-Abreu, LPC
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• Landon Matthew Pratt, MD
• Raley'S Arizona LLC
• Bradley R Register, P.A.-C

• All providers in Nogales, AZ
• Contractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.