Individual provider Active NPI

Oscar Orlando Campuzano Jr., PA-C

  • Physician Assistant
  • Gilbert, AZ
National Provider Identifier
1629663133
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8774 Issued in AZ
Practice address
1920 N Higley Rd Ste 206
Gilbert, AZ 85234-1624
Phone
(480) 543-6700
Fax
(480) 543-6725
NPI assigned
Mar 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8774 AZ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1920 N Higley Rd Ste 206
Gilbert, AZ 85234-1624

Mailing address

1920 N Higley Rd Ste 206
Gilbert, AZ 85234-1624
Phone (480) 543-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20211108001816 AZ Practitioner - Physician Assistant 8921497256 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Physician Specialists Arizona LLCGroup PAC ID 6204002272, 371 clinicians

Practice addresses (Care Compare)

10401 W Thunderbird Blvd
Sun City, AZ 85351-3004
Phone (623) 832-4000

1400 S Dobson Rd
Banner Health Clinic
Mesa, AZ 85202-4707
Phone (480) 412-3000

1920 N Higley Rd
Suite 206
Gilbert, AZ 85234-1624
Phone (480) 543-6700

6644 E Baywood Ave
Banner Health Clinic
Mesa, AZ 85206-1747
Phone (480) 321-2000

9165 W Thunderbird Rd
Suite 200
Peoria, AZ 85381-4847
Phone (623) 285-1120

Hospital & facility affiliations

  • Banner Baywood Medical Center Hospital, Mesa, AZ, CCN 030088

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8774AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 1, 2023 Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
Banner Physician Specialists Arizona LLC CurrentSince Jun 1, 2023 Accepting new patients
Banner Physician Specialists Arizona LLC Current Accepting new patients

Locations

1125 S Alma School Rd
Ste 210
Chandler, AZ 85286
Phone (480) 256-4900

1920 N Higley Rd
Ste 206
Gilbert, AZ 85234
Phone (480) 543-6700

9165 W Thunderbird Rd
Ste 200
Peoria, AZ 85381
Phone (623) 285-1120

500 W Thomas Rd
Ste 100
Phoenix, AZ 85013
Phone (602) 406-1115

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

File 56765
Los Angeles, CA 90074

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1629663133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 N HIGLEY RD STE 206",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341624",
            "telephone_number": "480-543-6700",
            "fax_number": "480-543-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 N HIGLEY RD STE 206",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852341624",
            "telephone_number": "480-543-6700",
            "fax_number": "480-543-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPUZANO",
        "first_name": "OSCAR",
        "middle_name": "ORLANDO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-05",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8774",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.