NPIMap

Individual provider Active NPI

Nelio Guzman Aguayo, M.D.

  • Nephrology Physician
  • Spokane, WA
National Provider Identifier
1124266184
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD60321439 Issued in WA
Practice address
105 W 8TH Ave
Suite 7060
Spokane, WA 99204-2302
Phone
(509) 747-2054
Fax
(509) 747-2054
NPI assigned
Jan 29, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X P0396 TX
Pediatric Nephrology Physician 2080P0210X P0396 TX
Pediatric Nephrology Physician 2080P0210X MD60321439 WA
Nephrology Physician 207RN0300X MD60321439 WA Primary

Addresses

Primary practice location

105 W 8TH Ave
Suite 7060
Spokane, WA 99204-2302

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (509) 474-2072

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nguzmanaguayo298664@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130911000330 WA Practitioner - Nephrology 5092959106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307

105 W 8TH Ave
Spokane, WA 99204-2312

1200 E Columbia Ave
Colville, WA 99114-3354
Phone (509) 684-3701

5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 482-0111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P0396TXMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Dec 15, 2015 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

105 W 8th Ave
Ste 7060
Spokane, WA 99204
Phone (509) 474-5437

105 W 8th Ave
Ste 7030
Spokane, WA 99204
Phone (509) 474-6560

101 W 8th Ave
Ste 100
Spokane, WA 99204
Phone (509) 474-2880

Interoperability endpoints

  • Direct secure messaging: nguzmanaguayo298664@wm.providencedirect.org

Organizations & group practices 2

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 8

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": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1124266184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-474-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 8TH AVE",
            "address_2": "SUITE 7060",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042302",
            "telephone_number": "509-747-2054",
            "fax_number": "509-747-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN AGUAYO",
        "first_name": "NELIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-29",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "P0396",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "TX",
            "license": "P0396",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "WA",
            "license": "MD60321439",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60321439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nguzmanaguayo298664@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "105 W 8th Ave",
            "address_2": "Suite 7060",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992042302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.