Alexander Jay Camarillo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT300103 Issued in CA

Practice address

27620 Landau Blvd Ste 3
Cathedral City, CA 92234-5540

Phone

(760) 322-5090

Fax

(760) 322-9175

NPI assigned

Apr 12, 2021

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aegis Physical Therapy, Inc.Group PAC ID 7315905189, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Aegis Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Cathedral City, CA
  • NPI 1477753861

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1619557782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27620 LANDAU BLVD STE 3",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345540",
            "telephone_number": "760-322-5090",
            "fax_number": "760-322-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27620 LANDAU BLVD STE 3",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345540",
            "telephone_number": "760-322-5090",
            "fax_number": "760-322-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMARILLO",
        "first_name": "ALEXANDER",
        "middle_name": "JAY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT300103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
            "identifier": "PT300103",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Paul Butzko
• Maryrose Cachola, BCBA
• California Behavioral Health, LLC
• Calmed Hospice Care, Inc
• Fabian Camarena-Huerta
• Ernest U Campos, DO
• Peter N Capobianco, RPH
• Gina M Caravaglia, DO
• John Lewis Carey, PT
• Caring Rose Human Services

• Physical Therapist in Cathedral City, CA
• Providers in Cathedral City, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.