Individual provider Active NPI

Gustavo David Aguirre, VMD, PHD

  • Veterinarian
  • Philadelphia, PA
National Provider Identifier
1053660993
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
BV003839L Issued in PA
Practice address
6419 Overbrook Ave
Philadelphia, PA 19151-2414
Phone
(215) 879-2757
NPI assigned
Sep 6, 2012
Last updated
Sep 6, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X BV003839L PA Primary

Addresses

Primary practice location

6419 Overbrook Ave
Philadelphia, PA 19151-2414

Mailing address

6419 Overbrook Ave
Philadelphia, PA 19151-2414
Phone (215) 879-2757

Other identifiers 1

IdentifierTypeStateIssuer
0140565OtherPAVETERINARIAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
BV003839LPAMDVeterinarian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1053660993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6419 OVERBROOK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191512414",
            "telephone_number": "215-879-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6419 OVERBROOK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191512414",
            "telephone_number": "215-879-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUIRRE",
        "first_name": "GUSTAVO",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "VMD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-06",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "PA",
            "license": "BV003839L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VETERINARIAN",
            "identifier": "0140565",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.