Active NPI
Michael Calica Agustin, M.D.
- Pulmonary Disease Physician
- Dededo, GU
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- M1976
- Practice address
- 133 Route 3
Dededo, GU 96929-6911 - Phone
- (671) 645-5500
- Fax
- (671) 969-4894
- NPI assigned
- Jun 23, 2010
- Last updated
- May 23, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | LP02041 | RI | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 250235 | MA | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | M1976 | GU | |
| Pulmonary Disease Physician | 207RP1001X | 250235 | MA | |
| Pulmonary Disease Physician | 207RP1001X | M1976 | GU | Primary |
Addresses
Primary practice location
133 Route 3
Dededo, GU 96929-6911
Mailing address
133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500
Other practice location 1
736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-2545
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GU
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500
548 S Marine Corps Dr
Tamuning, GU 96913-3539
Phone (671) 646-5825
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.22 of 100
- Quality
- 78.84
- Improvement activities
- 40
- Cost
- 61.61
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP02041 | RI | MD | Internal Medicine Physician |
| M1976 | GU | MD | Pulmonary Disease Physician |
| 250235 | MA | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Guam Healthcare Development Incorporated | Current | Accepting new patients | |
| Takecare Insurance Company Inc. | Internal Medicine | Current | Accepting new patients |
Locations
133 Route 3
Dededo, GU 96929
Phone (671) 645-5500
548 S Marine Corps Dr
Tamuning, GU 96913
Phone (671) 646-5824
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba GRMC Specialty Care Center
- Clinic/Center
- Dededo, GU
- NPI 1326447939
-
dba FHP Health Center
- Health Service Clinic/Center
- Tamuning, GU
- NPI 1972565240
Internal Medicine
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Guam Regional Medical City
- General Acute Care Hospital
- Dededo, GU
- NPI 1194159525
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558569600000",
"number": "1215248356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 ROUTE 3",
"city": "DEDEDO",
"state": "GU",
"postal_code": "969296911",
"telephone_number": "671-645-5500",
"fax_number": "671-969-4894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 ROUTE 3",
"city": "DEDEDO",
"state": "GU",
"postal_code": "969296911",
"telephone_number": "671-645-5500",
"fax_number": "671-969-4894"
}
],
"practiceLocations": [
{
"address_1": "736 Cambridge St",
"address_purpose": "LOCATION",
"city": "Brighton",
"state": "MA",
"postal_code": "021352907",
"country_code": "US",
"telephone_number": "617-789-2545",
"fax_number": "617-789-2893",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AGUSTIN",
"first_name": "MICHAEL",
"middle_name": "CALICA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-23",
"last_updated": "2019-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "LP02041",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "MA",
"license": "250235",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "GU",
"license": "M1976",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MA",
"license": "250235",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "GU",
"license": "M1976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dededo, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.