Fernando Aguirre Amezquita, M.D.
Individual provider Active NPI Obstetrics & Gynecology Physician · Springfield, IL
NPI 1457766727 · NPPES record last updated Jun 25, 2014
Key facts
- NPI
- 1457766727
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 125065574 (IL)
- Practice address
- 415 N 9TH St
Springfield, IL 62702-5303 - Phone
- (217) 545-5117
- Fax
- (217) 545-9217
- NPI assigned
- Jun 25, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Cloud Hospital
Practice addresses (Care Compare)
1406 6TH Ave N
Saint Cloud, MN 56303-1900
Phone (320) 251-2700
Hospital & facility affiliations
- Centracare - St. Cloud Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210629002485 | MN | Practitioner - Obstetrics/Gynecology | 9133425358 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Cloud Hospital | Current | Accepting new patients | |
| St. Cloud Hospital | Current |
Accepting new patients | |
| Centracare Clinic | Current |
Accepting new patients | |
| Centracare Clinic | Current | Accepting new patients | |
| St. Cloud Hospital | Current |
Accepting new patients | |
| Centracare Clinic | Current |
Accepting new patients | |
| Centracare Clinic | Past | 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
- faguirreamezquita585637@direct.centracare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 125065574 | IL | Yes |
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
Other providers in Springfield, IL
- Anthony Ray Agatucci
- Jeffrey H Agee
- Mohammed Hamza Ageel
- Bhuvnesh Aggarwal
- Sachin Aggarwal
- Frank V Aguirre
- Sajida Ahad
- Mohamed Farooq Ahamed
- Marci Diane Aherin
- Haleema Ahmad
All providers in Springfield, IL · Obstetrics & Gynecology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2014. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.