Joshua Azucena

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601012070 Issued in MI

Practice address

32100 Telegraph Rd Ste 205
Bingham Farms, MI 48025-2454

Phone

(248) 712-4266

NPI assigned

Sep 29, 2020

Reactivated

Nov 7, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Matthew D Andrews DPM PC

  dba Atlas Foot, Ankle and Wound Care

  • Foot & Ankle Surgery Podiatrist
  • Troy, MI
  • NPI 1992363097
  Medicare reassignment

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1649887001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32100 TELEGRAPH RD STE 205",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252454",
            "telephone_number": "248-712-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32100 TELEGRAPH RD STE 205",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252454",
            "telephone_number": "248-712-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZUCENA",
        "first_name": "JOSHUA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-29",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "deactivation_date": "2023-11-03",
        "reactivation_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Authentic, Inc.
• Elizabeth C Aversa
• Shawnice Avery
• Adriana Ayala
• Haya Azkoul
• Marissa Elizabeth Baca, MD
• Jeanette A Bacci, FNP
• Neal Bachert
• Ashley Rose Bailey
• Daria Imani Bailey

• Physician Assistant in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.