JESIRAE JUAREZ – Speech-Language Pathologist, NPI 1114695764

JESIRAE JUAREZ is a healthcare provider. based in Phoenix, Arizona. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold a License No. SLP9252 (AZ). The NPI Number for JESIRAE JUAREZ is 1114695764

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
JESIRAE JUAREZ
NPI
1114695764
Phone
Not provided
Address
1229 E CAMPBELL AVE
Enumeration Date
31 August 2021
Last Update Date
31 August 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8777578353
Graduation Year
2014 (12 years ago)
PAC ID
6406332758
Group Practice PAC ID
5890972335
Professional Enrollment ID
I20260107002780
Address ID
CA926181350IR530XXDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

206 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in AZ

Provider Addresses for JESIRAE JUAREZ

  • 1229 E CAMPBELL AVE

    PHOENIX, AZ 850144204

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-01-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260107001986IQualified Speech Language PathologistAZTBD
I20260107002780IQualified Speech Language PathologistCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 85014)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5890972335View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Physical Therapist In Private PracticeCA
Qualified Speech Language PathologistTX
Physical Therapist In Private PracticeCA
Occupational Therapist In Private PracticePA
Qualified Speech Language PathologistFL

Reviews

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Frequently asked questions

What is the standard ID for JESIRAE JUAREZ in the U.S.?
In the U.S., JESIRAE JUAREZ is identified by NPI 1114695764.
Is JESIRAE JUAREZ's NPI status active today?
Active status means JESIRAE JUAREZ's NPI record is not deactivated in the public file.
What type of care does JESIRAE JUAREZ provide?
JESIRAE JUAREZ's profile centers on Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to JESIRAE JUAREZ?
JESIRAE JUAREZ is associated with Phoenix, Arizona in the same public data insurers reference.
Can I export JESIRAE JUAREZ's record?
You can download the official NPPES record; we summarize key fields for readability.

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