NPIMap

Organization Active NPI

Jorge a Aguilar MD PA

  • Internal Medicine Physician
  • Jacksonville Beach, FL
National Provider Identifier
1003874553
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JORGE A AGUILAR MD PA
Practice address
905 Beach Blvd
Jacksonville Beach, FL 32250
Phone
(904) 241-8300
Fax
(904) 241-0831
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Authorized official

Name
Jorge A Aguilar, MDNPI 1679531115
Title
MD President
Phone
(904) 241-8300

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

905 Beach Blvd
Jacksonville Beach, FL 32250

Mailing address

905 Beach Blvd
Jacksonville Beach, FL 32250
Phone (904) 241-8300

Other identifiers 4

IdentifierTypeStateIssuer
K1966OtherFLMEDICARE GROUP
45775OtherFLBCBS GROUP
049551400MedicaidFL
69933OtherFLAETNA GROUP

Other names 1

  • Jorge Jacksonville Co Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040902000519 FL Part B Supplier - Clinic/Group Practice 1658347562 Receives reassigned benefits from 5 practitioners
Practice locations: Jacksonville Beach, FL

National Provider Directory

National Provider Directory

Locations

905 Beach Blvd
Ste A
Jax Bch, FL 32250
Phone (904) 241-8300

Practitioners & affiliated clinicians

Practitioners 6

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": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1003874553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 BEACH BLVD",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "32250",
            "telephone_number": "904-241-8300",
            "fax_number": "904-241-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 BEACH BLVD",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "32250",
            "telephone_number": "904-241-8300",
            "fax_number": "904-241-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORGE A AGUILAR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "AGUILAR",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD PRESIDENT",
        "authorized_official_telephone_number": "904-241-8300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K1966",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "45775",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049551400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP",
            "identifier": "69933",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jorge Jacksonville Co",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.