ANDREW JACKSON CAMARGO (FNP-C) – Family Nurse Practitioner, NPI 1164318622

ANDREW JACKSON CAMARGO (FNP-C) is a healthcare provider. based in Fontana, California. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 95037457 (CA). The NPI Number for ANDREW JACKSON CAMARGO (FNP-C) is 1164318622

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
ANDREW JACKSON CAMARGO (FNP-C)
NPI
1164318622
Phone
(909) 429-2864
Address
16465 SIERRA LAKES PKWY STE 300
Enumeration Date
13 June 2025
Last Update Date
28 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9094292864
Graduation Year
2025 (1 year ago)
PAC ID
3577054220
Group Practice PAC ID
6709899883
Professional Enrollment ID
I20251111002102
Address ID
CA923361242FO16465PKWY479
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

16,360 NURSE PRACTITIONER in CA

Provider Addresses for ANDREW JACKSON CAMARGO (FNP-C)

  • 16465 SIERRA LAKES PKWY STE 300

    FONTANA, CA 923361242

    Phone: (909) 429-2864

    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: 2025-11-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20251111002102INurse PractitionerCATBD

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 92336)

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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: 6709899883View full group profile
NameSpecialtyState
Physician AssistantCA
Family PracticeCA
Family PracticeCA
Physician AssistantCA
Nurse PractitionerCA
Nurse PractitionerCA
Physician AssistantCA
Physician AssistantCA
Physician AssistantCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

Does ANDREW JACKSON CAMARGO (FNP-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — ANDREW JACKSON CAMARGO (FNP-C) uses 1164318622.
Does the file indicate ANDREW JACKSON CAMARGO (FNP-C) is practicing under active NPI?
Directory data currently reports ANDREW JACKSON CAMARGO (FNP-C) as active.
What healthcare role does ANDREW JACKSON CAMARGO (FNP-C) hold?
Scheduling teams often label ANDREW JACKSON CAMARGO (FNP-C) under Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for ANDREW JACKSON CAMARGO (FNP-C)?
ANDREW JACKSON CAMARGO (FNP-C)'s geographic hint is Fontana, California in our summary view.
Is the information about ANDREW JACKSON CAMARGO (FNP-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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