Individual provider Active NPI

Anthony Ryan Miguel Aguirre, MD

  • Family Medicine Physician
  • Concord, CA
National Provider Identifier
1386907624
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A120738 Issued in CA
Practice address
5167 Clayton Rd Ste H
Concord, CA 94521-3170
Phone
(925) 489-2984
Fax
(925) 204-2174
NPI assigned
Jun 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A120738 CA Primary

Addresses

Primary practice location

5167 Clayton Rd Ste H
Concord, CA 94521-3170

Mailing address

5167 Clayton Rd Ste H
Concord, CA 94521-3170
Phone (925) 489-2984

Other practice location 1

1 Quality Dr
Vacaville, CA 95688-9494
Phone (707) 651-3960

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group
SOAP URL https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA, OR3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20121003000646 CA Practitioner - Family Practice 2163671363 Reassigns benefits to 2 organizations
I20240808003039 WA Practitioner - Family Practice 2163671363 Reassigns benefits to 1 organization
I20240809003589 OR Practitioner - Family Practice 2163671363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1001 Riverside Ave
Roseville, CA 95678-5134
Phone (916) 784-4050

3175 NE Aloclek Dr
Hillsboro, OR 97124-7135
Phone (800) 813-2000

5167 Clayton Rd
Suite H
Concord, CA 94521-3170
Phone (925) 375-1971

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A120738CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Family Medicine CurrentSince Apr 11, 2016 Accepting new patients
Permanente Medical Group, Inc CurrentSince Apr 11, 2016 Accepting new patients
Vividlife Ketamine Clinic CurrentSince Feb 10, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Aug 5, 2024 Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 5, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Aug 5, 2024 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

5167 Clayton Rd
Ste H
Concord, CA 94521
Phone (925) 375-1971

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

1001 Riverside Ave
Roseville, CA 95678
Phone (916) 784-4050

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

1 Quality Dr
Vacaville, CA 95688
Phone (707) 453-5000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

3175 NE Aloclek Dr
Hillsboro, OR 97124
Phone (503) 240-6148

500 NE Multnomah St
Fl 11
Portland, OR 97232

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1386907624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5167 CLAYTON RD STE H",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945213170",
            "telephone_number": "925-489-2984",
            "fax_number": "925-204-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5167 CLAYTON RD STE H",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945213170",
            "telephone_number": "925-489-2984",
            "fax_number": "925-204-2174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Quality Dr",
            "address_purpose": "LOCATION",
            "city": "Vacaville",
            "state": "CA",
            "postal_code": "956889494",
            "country_code": "US",
            "telephone_number": "707-651-3960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUIRRE",
        "first_name": "ANTHONY RYAN",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-21",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A120738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1001 Riverside Ave",
            "city": "Roseville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956785134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Careequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "2405 N Franklin St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802055437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

Verify at the official NPI Registry.