Active NPI
Nelson Ivan Aguinaga, RN, FNP
- Family Nurse Practitioner
- Fullerton, CA
National Provider Identifier
1043909609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95024052
- Practice address
- 101 E Valencia Mesa Dr
Fullerton, CA 92835-3809 - Phone
- (714) 871-3280
- NPI assigned
- May 1, 2023
- Last updated
- May 1, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95024052 | CA | Primary |
Addresses
Primary practice location
101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Mailing address
12163 Serra Ave
Chino, CA 91710-2325
Phone (909) 248-6323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4646 Brockton Ave
Suite 203
Riverside, CA 92506-0102
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95024052 | CA | MD | Family Nurse Practitioner |
Interoperability endpoints
- nelson.aguinaga@403277232537604.direct.elationemr.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Riverside, CA
- NPI 1194712315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682899200000",
"number": "1043909609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12163 SERRA AVE",
"city": "CHINO",
"state": "CA",
"postal_code": "917102325",
"telephone_number": "909-248-6323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E VALENCIA MESA DR",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928353809",
"telephone_number": "714-871-3280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGUINAGA",
"first_name": "NELSON",
"middle_name": "IVAN",
"credential": "RN, FNP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-01",
"last_updated": "2023-05-01",
"certification_date": "2023-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95024052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.