Individual provider Active NPI

Michael Jaramillo, D.C.

  • Chiropractor
  • San Clemente, CA
National Provider Identifier
1730260282
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC23283 Issued in CA
Practice address
616 S El Camino Real
G3
San Clemente, CA 92672-4298
Phone
(949) 429-4062
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC23283 CA Primary

Addresses

Primary practice location

616 S El Camino Real
G3
San Clemente, CA 92672-4298

Mailing address

15550 Rockfield Blvd
B220
Irvine, CA 92618-2720
Phone (949) 598-9999

Other identifiers 1

IdentifierTypeStateIssuer
DC0232830OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220505000235 AZ Practitioner - Chiropractic 0840282125 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Wojciak Enterprises IncGroup PAC ID 2860594496, 5 clinicians

Practice addresses (Care Compare)

1590 Willow Creek Rd
Prescott, AZ 86301-1164
Phone (928) 227-1899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9150AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Wojciak Enterprises Inc CurrentSince Mar 17, 2022 Accepting new patients
Unlimited Health Chiropractic PastSince Feb 5, 2020 Accepting new patients

Locations

1590 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 227-1899

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1730260282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15550 ROCKFIELD BLVD",
            "address_2": "B220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182720",
            "telephone_number": "949-598-9999",
            "fax_number": "949-598-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 S EL CAMINO REAL",
            "address_2": "G3",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724298",
            "telephone_number": "949-429-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "DC0232830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.