Active NPI
Kaitlin Aquino, PA-C
- Physician Assistant
- Long Beach, CA
National Provider Identifier
1609491158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 855 E Anaheim St
Long Beach, CA 90813-3550 - Phone
- (562) 591-0840
- Fax
- (562) 591-4181
- NPI assigned
- Jun 10, 2020
- Last updated
- Aug 3, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | CA | Primary |
Addresses
Primary practice location
855 E Anaheim St
Long Beach, CA 90813-3550
Mailing address
855 E Anaheim St
Long Beach, CA 90813-3550
Phone (562) 591-0840
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
709 E Anaheim St
Long Beach, CA 90813-3507
Phone (562) 591-0840
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Long Beach, CA
- NPI 1740649672
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627948800000",
"number": "1609491158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 E ANAHEIM ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133550",
"telephone_number": "562-591-0840",
"fax_number": "562-591-4181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 E ANAHEIM ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908133550",
"telephone_number": "562-591-0840",
"fax_number": "562-591-4181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AQUINO",
"first_name": "KAITLIN",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-10",
"last_updated": "2021-08-03",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.