Erie T Agustin, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

196473 Issued in NY

Practice address

5718 Woodside Ave FL 2
Woodside, NY 11377-3415

Phone

(718) 205-0030

Fax

(718) 205-6136

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Catskill Regional Medical Center

  • Family Medicine Physician
  • Monticello, NY
  • NPI 1720039563
  NPD (past)
• Eta Medical Management Inc

  • Internal Medicine Physician
  • Woodside, NY
  • NPI 1336900836
  NPD (past)
• Lifeco Medical, P.C.

  • Emergency Medicine Physician
  • Forest Hills, NY
  • NPI 1922031905
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1407892144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5718 WOODSIDE AVE FL 2",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773415",
            "telephone_number": "718-205-0030",
            "fax_number": "718-205-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5718 WOODSIDE AVE FL 2",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773415",
            "telephone_number": "718-205-0030",
            "fax_number": "718-205-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "ERIE",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "196473",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "196473",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01551775",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natasha Agard
• Jeremiah Agtarap, RN
• Trinidad Delacruz Agtarap, GNP-BC
• Gero Patrick Rojas Aguilar
• Laura Aguilera, RN
• Frishta Ahmadi, COTA
• Aftab Ahmed
• Hadil Ahmed, MD
• Nahida Ahmed
• Niaz Ahmed

• Family Medicine Physician in Woodside, NY
• Providers in Woodside, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.