Individual provider Active NPI

Denise Aguilar, RN PA NP

  • Physician Assistant
  • Fresno, CA
National Provider Identifier
1124186614
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15084 Issued in CA
Practice address
1377 E Herndon Ave
Suite 104
Fresno, CA 93720-3022
Phone
(559) 450-7455
Fax
(559) 450-7473
NPI assigned
Dec 5, 2006
Last updated
Jan 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15084 CA Primary
Nurse Practitioner 363L00000X 10980 CA

Addresses

Primary practice location

1377 E Herndon Ave
Suite 104
Fresno, CA 93720-3022

Mailing address

1377 E Herndon Ave
Suite 104
Fresno, CA 93720-3022
Phone (559) 450-7455

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
I20140130000754 CA Practitioner - Physician Assistant 3072577493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.57 of 100Reported as group
Quality
63.43
Promoting interoperability
98
Improvement activities
40
Cost
77.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA15084CAMDPhysician Assistant
10980CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LQMG Medical Group Inc. Current Accepting new patients
Stanford Health Care Past Accepting new patients
Valley Cardiac Surgery Medical Group PastSince Jan 1, 2010 Accepting new patients

Locations

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

Interoperability endpoints

  • Direct secure messaging: daguilar2714917@direct.trinity-health.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1124186614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 E HERNDON AVE",
            "address_2": "SUITE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203022",
            "telephone_number": "559-450-7455",
            "fax_number": "559-450-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 E HERNDON AVE",
            "address_2": "SUITE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203022",
            "telephone_number": "559-450-7455",
            "fax_number": "559-450-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "RN PA NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15084",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "10980",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.