Active NPI
Richard J Navarez Jr., PA-C
- Physician Assistant
- Usaf Academy, CO
National Provider Identifier
1619159456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.0005340
- Practice address
- 2355 Faculty Dr
Usaf Academy, CO 80840-1805 - Phone
- (719) 333-5950
- NPI assigned
- Dec 4, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1080515 | NJ | |
| Physician Assistant | 363A00000X | PA.0005340 | CO | Primary |
Addresses
Primary practice location
2355 Faculty Dr
Usaf Academy, CO 80840-1805
Mailing address
2355 Faculty Dr
Usaf Academy, CO 80840-1805
Phone (719) 333-5950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.0005340 | CO | MD | Physician Assistant |
| 1080515 | NJ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1619159456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2355 FACULTY DR",
"city": "USAF ACADEMY",
"state": "CO",
"postal_code": "808401805",
"telephone_number": "719-333-5950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2355 FACULTY DR",
"city": "USAF ACADEMY",
"state": "CO",
"postal_code": "808401805",
"telephone_number": "719-333-5950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAVAREZ",
"first_name": "RICHARD",
"middle_name": "J",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-04",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "1080515",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0005340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Usaf Academy, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.