Individual provider Active NPI

Nelson Ivan Aguinaga, RN, FNP

  • Family Nurse Practitioner
  • Fullerton, CA
National Provider Identifier
1043909609
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95024052 Issued in CA
Practice address
101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Phone
(714) 871-3280
NPI assigned
May 1, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260622000215 CA Practitioner - Nurse Practitioner 9032682174 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
95024052CAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: 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 and National Provider Directory roles.

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

Verify at the official NPI Registry.