Individual provider Active NPI

Richard Cortez Camarillo, MSN, APRN, AGPCNP-C

  • Gerontology Nurse Practitioner
  • Brownsville, TX
National Provider Identifier
1982476321
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1140659 Issued in TX
Practice address
11 E Hawthorne St
Brownsville, TX 78520-7711
Phone
(956) 433-9364
NPI assigned
Oct 30, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1140659 TX Primary

Addresses

Primary practice location

11 E Hawthorne St
Brownsville, TX 78520-7711

Mailing address

11 E Hawthorne St
Brownsville, TX 78520-7711
Phone (956) 433-9364

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240503003231 TX Practitioner - Nurse Practitioner 8325488562 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
JK Sun Valley Healthcare Associates PAGroup PAC ID 7214989938, 4 clinicians
Hania Medical Associates PLLCGroup PAC ID 2365987955, 4 clinicians

Practice addresses (Care Compare)

2686 W Alton Gloor Blvd
Suite 1
Brownsville, TX 78520-4055
Phone (956) 350-5444

327 W Ocean Blvd
Los Fresnos, TX 78566-3627
Phone (956) 233-2933

Hospital & facility affiliations

  • Sunrise Health Care Services LTD Home health agency, McAllen, TX, CCN 679436
  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1140659TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JK Sun Valley Healthcare Associates PA CurrentSince Mar 27, 2024 Accepting new patients
Hania Medical Associates PLLC CurrentSince May 5, 2024 Accepting new patients

Locations

2686 W Alton Gloor Blvd
Ste 1
Brownsville, TX 78520
Phone (956) 350-5444

327 W Ocean Blvd
Los Fresnos, TX 78566
Phone (956) 233-2933

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 3

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": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1982476321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 E HAWTHORNE ST",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785207711",
            "telephone_number": "956-433-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 E HAWTHORNE ST",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785207711",
            "telephone_number": "956-433-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMARILLO",
        "first_name": "RICHARD",
        "middle_name": "CORTEZ",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, AGPCNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1140659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.