Individual provider Active NPI

Miguel A Aguilera, MD

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Centralia, IL
National Provider Identifier
1366616864
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
License
036072026 Issued in IL
Practice address
400 N Pleasant Ave
Centralia, IL 62801-3098
Phone
(618) 436-6318
Fax
(618) 436-6386
NPI assigned
Apr 15, 2008
Last updated
Feb 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 67178 WI
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 036072026 IL Primary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 67178 WI

Addresses

Primary practice location

400 N Pleasant Ave
Centralia, IL 62801-3098

Mailing address

400 N Pleasant Ave
Centralia, IL 62801-3098
Phone (618) 436-6318

Other practice location 1

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036072026ILMDUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
67178WIMDUndersea and Hyperbaric Medicine (Preventive Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1366616864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PLEASANT AVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013098",
            "telephone_number": "618-436-6318",
            "fax_number": "618-436-6386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PLEASANT AVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013098",
            "telephone_number": "618-436-6318",
            "fax_number": "618-436-6386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 S Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Cudahy",
            "state": "WI",
            "postal_code": "53110",
            "country_code": "US",
            "telephone_number": "414-489-4058",
            "fax_number": "414-489-4710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUILERA",
        "first_name": "MIGUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "67178",
            "primary": false
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "IL",
            "license": "036072026",
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "WI",
            "license": "67178",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.