Deogracias Remandaban Agnila Jr., NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN9256167 Issued in FL

Practice address

6488 103Rd St Ste B
Jacksonville, FL 32210-7161

Phone

(904) 450-6810

Fax

(904) 450-6729

NPI assigned

Apr 3, 2018

Sex

Male

Sole proprietor

Yes

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.

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124

  FL

  Medicare reassignment Care Compare group NPD
• St Vincent'S Full Service Urgent Care, LLC

  • Occupational Medicine Clinic/Center
  • Jacksonville, FL
  • NPI 1750672051

  FL

  Medicare reassignment
• St Vincents Ambulatory Care Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD

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

• Ascension Health at Home of Florida I, LLC

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1811590961

  Home health agency

  Care Compare affiliation
• St Lukes - St Vincents Healthcare

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1396926747

  Hospital

  Care Compare affiliation
• St Vincents Medical Center Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1134117575

  Hospital

  Care Compare affiliation
• St. Vincent'S Medical Center, Inc.

  • Clinical Medical Laboratory
  • Jacksonville, FL
  • NPI 1669556072

  Hospital

  Care Compare affiliation

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Vincent'S Ambulatory Care Inc 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Health at Home of Florida 1 LLC Home health agency, Jacksonville, FL, CCN 683147
• Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307
• Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

Medicare fee-for-service enrollment

Enrolled in FL

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: deogracias.agnila.1@8967.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 20, 2018.

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1154827798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6488 103RD ST STE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322107161",
            "telephone_number": "904-450-6810",
            "fax_number": "904-450-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNILA",
        "first_name": "DEOGRACIAS",
        "middle_name": "REMANDABAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "9256167",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9256167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aging Grace Enterprises LLC
• Aging Grace LLC
• Danielle Rae Agnello
• Agnes Street Home for the Elderly
• Concepcion Latoza Agnila, M.D.
• Agr Multiservices Inc
• Agr Transportation, LLC
• Mario Agrait Bertran, MD
• Edgardo Alberto Agrait-Bertran, M.D.
• Kristina Agranat, ARNP-BC

• All providers in Jacksonville, FL
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.