Organization Active NPI

Larissa Camejo, MD.PA.

  • Ophthalmology Physician
  • Palm Beach Gardens, FL
National Provider Identifier
1871949701
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME106908 Issued in FL
Legal business name
LARISSA CAMEJO, MD.PA.
Practice address
11211 Prosperity Farms Rd Ste D127
Palm Beach Gardens, FL 33410-3449
Phone
(561) 223-6557
Fax
(561) 526-8754
NPI assigned
May 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Dr. Larissa Camejo, MDNPI 1447286190
Title
Ophthalmologist, Glaucoma Specialis
Phone
(215) 888-8345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X ME106908 FL Primary

Addresses

Primary practice location

11211 Prosperity Farms Rd Ste D127
Palm Beach Gardens, FL 33410-3449

Mailing address

2105 Spring CT
Palm Beach Gardens, FL 33410-1297
Phone (215) 888-8345

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160801002275 FL Part B Supplier - Clinic/Group Practice 3274826037 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Beach Gardens, FL

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: lcamejo@larissacamejomd.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1871949701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 SPRING CT",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334101297",
            "telephone_number": "215-888-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD STE D127",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103449",
            "telephone_number": "561-223-6557",
            "fax_number": "561-526-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARISSA CAMEJO, MD.PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "CAMEJO",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST, GLAUCOMA SPECIALIS",
        "authorized_official_telephone_number": "215-888-8345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME106908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.