Individual provider Active NPI

Adolfo Aguilera, MD

  • Family Medicine Physician
  • Moreno Valley, CA
National Provider Identifier
1477609808
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A69022 Issued in CA
Practice address
26520 Cactus Ave
RM# B2018
Moreno Valley, CA 92555-3927
Phone
(951) 486-5610
Fax
(951) 486-5620
NPI assigned
Jan 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 A69022 CA Primary

Addresses

Primary practice location

26520 Cactus Ave
RM# B2018
Moreno Valley, CA 92555-3927

Mailing address

26520 Cactus Ave
RM# B2018
Moreno Valley, CA 92555-3927
Phone (951) 486-5610

Other identifiers 1

IdentifierTypeStateIssuer
00A690220MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20050408000968 CA Practitioner - Family Practice 1658318837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1997
Medicare assignment
May accept Medicare assignment
Group practices
Canyon Springs Medical Group IncGroup PAC ID 0446297634, 14 clinicians
County of RiversideGroup PAC ID 6507754488, 190 clinicians

Practice addresses (Care Compare)

26520 Cactus Ave
Moreno Valley, CA 92555-3927
Phone (951) 486-5610

308 E San Jacinto Ave
Perris, CA 92570-2878
Phone (951) 940-6700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
97
Improvement activities
40
Cost
79.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
69022CAMDPharmacist
A69022CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Riverside Current Accepting new patients
County of Riverside CurrentSince Sep 9, 2018 Accepting new patients

Locations

308 E San Jacinto Ave
Perris, CA 92570
Phone (951) 940-6700

Interoperability endpoints

  • Direct secure messaging: aaguilera100845@direct.llu.edu

Organizations & group practices 3

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 2

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477609808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "address_2": "RM# B2018",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-5610",
            "fax_number": "951-486-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "address_2": "RM# B2018",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-5610",
            "fax_number": "951-486-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILERA",
        "first_name": "ADOLFO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A69022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A690220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.