NPIMap

Individual provider Active NPI

Hector G Camacho Perez-Arce, PA-C

  • Physician Assistant
  • San Juan Capistrano, CA
National Provider Identifier
1760436968
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004193 Issued in WA
Practice address
27512 Calle Arroyo
Suite a
San Juan Capistrano, CA 92675-2753
Phone
(206) 714-1733
Fax
(949) 489-9342
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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 PA10004193 WA Primary
Medical Physician Assistant 363AM0700X PA19017 CA

Addresses

Primary practice location

27512 Calle Arroyo
Suite a
San Juan Capistrano, CA 92675-2753

Mailing address

27512 Calle Arroyo
Suite a
San Juan Capistrano, CA 92675-2753
Phone (206) 714-1733

Other identifiers 1

IdentifierTypeStateIssuer
8322521MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130404000409 CA Practitioner - Physician Assistant 7911892021 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10004193WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Scripps Health Physician Assistant Current Accepting new patients
Scripps Health CurrentSince Feb 1, 2019 Accepting new patients
Scripps Health CurrentSince Feb 1, 2019 Accepting new patients
Scripps Health Current Accepting new patients
Public Hospital District No. 4, King County Washington Past Accepting new patients
K. Mitchell Naficy MD Inc Past Accepting new patients
Pacific Palisades Podiatry PLLC Past Accepting new patients
Ballard Emergency Physicians, P.S. Past Accepting new patients
Peacehealth Past Accepting new patients
Public Hospital District No 4, King County Wa Physician Assistant Past Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

10790 Rancho Bernardo Rd
#4S205
San Diego, CA 92127
Phone (858) 605-7171

Interoperability endpoints

  • Direct secure messaging: hcamacho178799@scrippshlth.medalliesdirect.net
  • Direct secure messaging: hector.camacho.p1@direct.cdsdp.nextgenshare.com
  • Direct secure messaging: hector.camacho.perez-arce.1@15156.direct.athenahealth.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1760436968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27512 CALLE ARROYO",
            "address_2": "SUITE A",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752753",
            "telephone_number": "206-714-1733",
            "fax_number": "949-489-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27512 CALLE ARROYO",
            "address_2": "SUITE A",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926752753",
            "telephone_number": "206-714-1733",
            "fax_number": "949-489-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO PEREZ-ARCE",
        "first_name": "HECTOR",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004193",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA19017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8322521",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan Capistrano, CA

Sources for this page

Verify at the official NPI Registry.