NPIMap

Individual provider Active NPI

Fernando Aguirre Amezquita, M.D.

  • Obstetrics & Gynecology Physician
  • Springfield, IL
National Provider Identifier
1457766727
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
125065574 Issued in IL
Practice address
415 N 9TH St
Springfield, IL 62702-5303
Phone
(217) 545-5117
Fax
(217) 545-9217
NPI assigned
Jun 25, 2014
Last updated
Jun 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 125065574 IL Primary

Addresses

Primary practice location

415 N 9TH St
Springfield, IL 62702-5303

Mailing address

PO Box 19640
Springfield, IL 62794-9640
Phone (217) 545-5117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210629002485 MN Practitioner - Obstetrics/Gynecology 9133425358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Cloud HospitalGroup PAC ID 4880594779, 215 clinicians

Practice addresses (Care Compare)

1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centracare Clinic Current Accepting new patients
St. Cloud Hospital Current Accepting new patients
Centracare Clinic CurrentSince Oct 1, 2022 Accepting new patients
Centracare Clinic CurrentSince Oct 1, 2022 Accepting new patients
St. Cloud Hospital CurrentSince Jun 1, 2021 Accepting new patients
St. Cloud Hospital CurrentSince Jun 1, 2021 Accepting new patients
St. Cloud Hospital Past Accepting new patients

Locations

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657

110 2nd St S
Ste 104
Waite Park, MN 56387
Phone (320) 259-9375

Interoperability endpoints

  • Direct secure messaging: faguirreamezquita585637@direct.centracare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403654400000",
    "number": "1457766727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19640",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949640",
            "telephone_number": "217-545-5117",
            "fax_number": "217-545-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 9TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025303",
            "telephone_number": "217-545-5117",
            "fax_number": "217-545-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUIRRE AMEZQUITA",
        "first_name": "FERNANDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "125065574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.