David P. Agbunag, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

085002886 Issued in IL

Practice address

1725 W Harrison St
#1063
Chicago, IL 60612-3841

Phone

(312) 243-4244

Fax

(312) 243-2744

NPI assigned

Nov 8, 2006

Last updated

Jul 25, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Merit-based Incentive Payment System (MIPS)

Final score

95.95 of 100Reported as group

Quality

87.44

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Emergency Medicine Physicians of Franklin County, LTD

  • Emergency Medicine Physician
  • Columbus, OH
  • NPI 1538108501
  Medicare reassignment
• Observation Medicine Physicians of Champaign County, LTD

  • Emergency Medicine Physician
  • Springfield, OH
  • NPI 1164839726
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1093885188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WESTBROOK CORPORATE CTR",
            "address_2": "#240",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545701",
            "telephone_number": "708-236-2673",
            "fax_number": "708-236-2773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST",
            "address_2": "#1063",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123841",
            "telephone_number": "312-243-4244",
            "fax_number": "312-243-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBUNAG",
        "first_name": "DAVID",
        "middle_name": "P.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085002886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LOCALITY 15",
            "identifier": "209118",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LOCALITY 16",
            "identifier": "209119",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore Lord Agbemaple, MD
• Chinwike T Agbo, MD
• Alisha Agbonghae, LCSW
• Cheryl Agbonghae, NP
• Aderoju Falilat Agboola
• Nardin Mohsen Ageeb, DO
• Agefully
• Dolapo Ageh, PHARM,D
• Ageless Eye Care P.C.
• Ageless Men's Health Holdings Inc (Ageless Men's Health)

• Surgical Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Surgical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.

Verify at the official NPI Registry.