Individual provider Active NPI

Douglas Juarez, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Brawley, CA
National Provider Identifier
1700854007
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A51964 Issued in CA
Practice address
207 W Legion Rd
Brawley, CA 92227-7780
Phone
(760) 351-3432
Fax
(760) 351-3383
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A51964 CA Primary

Addresses

Primary practice location

207 W Legion Rd
Brawley, CA 92227-7780

Mailing address

PO Box 2311
Chatsworth, CA 91313-2311
Phone (818) 718-9500

Other identifiers 1

IdentifierTypeStateIssuer
00A519640MedicaidCA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040723000710 CA Practitioner - Pathology 7911987532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1415 Ross Ave
El Centro, CA 92243-4306
Phone (760) 604-4233

Hospital & facility affiliations

  • El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045
  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025
  • Pioneers Memorial Healthcare District Hospital, Brawley, CA, CCN 050342
  • Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
73.46
Improvement activities
40
Cost
73.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51964CAMDGeneral Practice Dentistry
A51964CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Pathology Inc., a California Professional Corporation Anatomic Pathology & Clinical Pathology CurrentSince Apr 2, 2025 Accepting new patients
Imperial Clinical & Pathology Lab LLC Current Accepting new patients

Locations

1415 Ross Ave
El Centro, CA 92243
Phone (760) 339-4045

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.

Hospital & facility affiliations 4

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700854007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2311",
            "city": "CHATSWORTH",
            "state": "CA",
            "postal_code": "913132311",
            "telephone_number": "818-718-9500",
            "fax_number": "818-718-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W LEGION RD",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277780",
            "telephone_number": "760-351-3432",
            "fax_number": "760-351-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A51964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A519640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brawley, CA

Sources for this page

Verify at the official NPI Registry.