Organization Active NPI

Edwin a. Aquino, M.D., P.C.

  • Specialist
  • Harrisburg, PA
National Provider Identifier
1366569774
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD027976E Issued in PA
Legal business name
EDWIN A. AQUINO, M.D., P.C.
Practice address
845 Sir Thomas CT
Suite 10
Harrisburg, PA 17109-4840
Phone
(717) 541-5406
Fax
(717) 541-5449
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Edwin Abella Aquino, M.D.NPI 1174596720
Title
Owner
Phone
(717) 541-5406

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD027976E PA Primary

Addresses

Primary practice location

845 Sir Thomas CT
Suite 10
Harrisburg, PA 17109-4840

Mailing address

845 Sir Thomas CT
Suite 10
Harrisburg, PA 17109-4840
Phone (717) 541-5406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101214000327 PA Part B Supplier - Clinic/Group Practice 1557558798 Receives reassigned benefits from 1 practitioner
Practice locations: Bloomsburg, PA; Harrisburg, PA; Selinsgrove, PA

National Provider Directory

National Provider Directory

Locations

845 Sir Thomas Ct
Ste 10
Harrisburg, PA 17109
Phone (717) 541-5406

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366569774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 SIR THOMAS CT",
            "address_2": "SUITE 10",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094840",
            "telephone_number": "717-541-5406",
            "fax_number": "717-541-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 SIR THOMAS CT",
            "address_2": "SUITE 10",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094840",
            "telephone_number": "717-541-5406",
            "fax_number": "717-541-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN A. AQUINO, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AQUINO",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "ABELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-541-5406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD027976E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.