Juan Pablo Clavijo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-08352 Issued in NC

Practice address

2406 Blue Ridge Rd Ste 170
Raleigh, NC 27607-6680

Phone

(919) 782-4884

Fax

(919) 782-4885

NPI assigned

Aug 21, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

International Clinic of the Carolinas PLLCGroup PAC ID 2365566924, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• International Clinic of the Carolinas PLLC

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1912228347
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1770063497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 BLUE RIDGE RD STE 170",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076680",
            "telephone_number": "919-782-4884",
            "fax_number": "919-782-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 BLUE RIDGE RD STE 170",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076680",
            "telephone_number": "919-782-4884",
            "fax_number": "919-782-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAVIJO",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Classic Home Health Care and Counseling Services
• Classic Home Health Care and Counseling Services
• Classical Psychotherapy PC
• Claudio Chiropractic and Wellness, PLLC (Triangle Spine Center)
• Cinnamon A Claudio, DC
• Aerial Clay
• Shannon Clay
• William Christopher Claypoole, DDS
• Clayton Hyakutake LLC
• Alyson Clayton

• Physician Assistant in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.
• 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.