Rogelio Aguirre, DPT
Individual provider Active NPI Physical Therapist · Rexburg, ID
NPI 1437795663 · NPPES record last updated Nov 22, 2019
Key facts
- NPI
- 1437795663
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- LPT-30993 (AZ)
- Practice address
- 711 Lupine Cir
Rexburg, ID 83440-1701 - Phone
- (323) 875-9764
- NPI assigned
- Nov 22, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NM, TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200107000957 | NM | Practitioner - Physical Therapist in Private Practice | 6608200225 | Reassigns benefits to 1 organization |
| I20241213000383 | TX | Practitioner - Physical Therapist in Private Practice | 6608200225 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPT-30993 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS, PHS, Naihs, Shiprock Hospital | Current |
Accepting new patients | |
| Apexnetwork New Mexico, LLC | Physical Therapist | Current |
Accepting new patients |
| DHHS, PHS, Naihs, Shiprock Hospital | Current |
Accepting new patients |
Locations
15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482
140 E Highway 550
Ste E3
Bernalillo, NM 87004
Phone (505) 404-8652
204 W Broadway Ave
#A
Bloomfield, NM 87413
Phone (505) 333-7217
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | LPT-30993 | AZ | Yes |
Addresses
Primary practice location
711 Lupine Cir
Rexburg, ID 83440-1701
Mailing address
711 Lupine Cir
Rexburg, ID 83440-1701
Phone (323) 875-9764
Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.