Individual provider Active NPI

Stacy Janices Aguirre

  • Family Nurse Practitioner
  • Galveston, TX
National Provider Identifier
1053807768
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP136741 Issued in TX
Practice address
400 Harborside
Galveston, TX 77550
Phone
(800) 917-8906
NPI assigned
Jul 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP136741 TX
Family Nurse Practitioner 363LF0000X AP136741 TX Primary

Addresses

Primary practice location

400 Harborside
Galveston, TX 77550

Mailing address

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180803002423 TX Practitioner - Nurse Practitioner 3678821881 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP136741TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Jul 20, 2018 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

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": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1053807768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HARBORSIDE",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "77550",
            "telephone_number": "800-917-8906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUIRRE",
        "first_name": "STACY",
        "middle_name": "JANICES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP136741",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.