Active NPI
Ernest V Juarez, PAC
- Physician Assistant
- Wildomar, CA
National Provider Identifier
1689758468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA16696
- Practice address
- 36243 Inland Valley Drive
Suite 180
Wildomar, CA 92595 - Phone
- (951) 600-0110
- Fax
- (951) 600-4645
- NPI assigned
- Oct 25, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA16696 | CA | Primary |
Addresses
Primary practice location
36243 Inland Valley Drive
Suite 180
Wildomar, CA 92595
Mailing address
36243 Inland Valley Drive
Suite 180
Wildomar, CA 92595
Phone (951) 600-0110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA16696 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| U S Healthworks Medical Group | Past | Accepting new patients |
Interoperability endpoints
- ernest.juarez.1@26729.direct.athenahealth.com
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201824000000",
"number": "1689758468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36243 INLAND VALLEY DRIVE",
"address_2": "SUITE 180",
"city": "WILDOMAR",
"state": "CA",
"postal_code": "92595",
"telephone_number": "951-600-0110",
"fax_number": "951-600-4645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36243 INLAND VALLEY DRIVE",
"address_2": "SUITE 180",
"city": "WILDOMAR",
"state": "CA",
"postal_code": "92595",
"telephone_number": "951-600-0110",
"fax_number": "951-600-4645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUAREZ",
"first_name": "ERNEST",
"middle_name": "V",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2008-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA16696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wildomar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.