Individual provider Active NPI

Kimberly Aguilar, DNP FNP-C, RN

  • Family Nurse Practitioner
  • Rancho Santa Margarita, CA
National Provider Identifier
1104539295
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95023608 Issued in CA
Practice address
29472 Avenida de Las Banderas
Rancho Santa Margarita, CA 92688
Phone
(949) 459-9968
Fax
(949) 766-2565
NPI assigned
Jan 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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 95023608 CA Primary

Addresses

Primary practice location

29472 Avenida de Las Banderas
Rancho Santa Margarita, CA 92688

Mailing address

29472 Avenida de Las Banderas
Rancho Santa Margarita, CA 92688
Phone (949) 459-9968

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

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
I20230116000668 CA Practitioner - Nurse Practitioner 9537530316 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

29472 Avenida de Las Bandera
Rancho Santa Margarita, CA 92688-2651
Phone (949) 459-9968

Hospital & facility affiliations

  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Merit-based Incentive Payment System (MIPS)

Final score
87.17 of 100Reported as group
Quality
81.15
Promoting interoperability
100
Improvement activities
40
Cost
71.64

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95023608CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Physical Medicine and Rehabilitation Inc. CurrentSince Dec 13, 2022 Accepting new patients
Memorialcare Medical Foundation CurrentSince Sep 9, 2024 Accepting new patients
Bristol Park Medical Group, Inc Past Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

17264 Red Hill Ave
Irvine, CA 92614
Phone (949) 650-1228

29472 Avenida de las Bandera
Rcho Sta Marg, CA 92688
Phone (949) 459-9968

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: kaguilar214595@direct.memorialcare.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1104539295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29472 AVENIDA DE LAS BANDERAS",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "92688",
            "telephone_number": "949-459-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29472 AVENIDA DE LAS BANDERAS",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "92688",
            "telephone_number": "949-459-9968",
            "fax_number": "949-766-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "KIMBERLY",
        "credential": "DNP FNP-C, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-04",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95023608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

Verify at the official NPI Registry.