Fidelito Boado Agcaoili, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-18803 Issued in CA

Practice address

4000 14TH Street
Ste. 208
Riverside, CA 92501-4136

Phone

(951) 369-6191

Fax

(951) 369-0304

NPI assigned

Jul 21, 2011

Last updated

Jul 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jacqueline G. Agcaoili, MD Corporation

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1639212574
  NPD (past)

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311206400000",
    "number": "1225316466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 14TH STREET",
            "address_2": "STE. 208",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014136",
            "telephone_number": "951-369-6191",
            "fax_number": "951-369-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 14TH STREET",
            "address_2": "STE. 208",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014136",
            "telephone_number": "951-369-6191",
            "fax_number": "951-369-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGCAOILI",
        "first_name": "FIDELITO",
        "middle_name": "BOADO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-21",
        "last_updated": "2011-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA-18803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samriddhi Agarwal
• Suman Agarwal, MD
• Edilberto Lumelay Agas Jr., M.D.
• Nelson A Agbagwu, LVN
• Jordan Agbulos
• Jacqueline Gesner Agcaoili, MD
• Alishba Agha
• Maryam Agha
• Agile Occupational Medicine, PC
• Grace M Agosto

• Physician Assistant in Riverside, CA
• Providers in Riverside, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.