NPIMap

Individual provider Active NPI

Jose Javier Aguayo, MD

  • Nephrology Physician
  • Lakeland, FL
National Provider Identifier
1609972728
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME74725 Issued in FL
Practice address
1745 Lakeland Hills Blvd
Lakeland, FL 33805
Phone
(863) 688-0576
Fax
(863) 686-5907
NPI assigned
Sep 15, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME74725 FL Primary

Addresses

Primary practice location

1745 Lakeland Hills Blvd
Lakeland, FL 33805

Mailing address

1745 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 688-0576

Other identifiers 1

IdentifierTypeStateIssuer
262845700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100820000488 FL Practitioner - NephrologyPractitioner - Internal Medicine 8527151679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Florida Kidney Care PAGroup PAC ID 2264525419, 4 clinicians

Practice addresses (Care Compare)

1745 Lakeland Hills Blvd
Lakeland, FL 33805-3016
Phone (863) 688-0576

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
84.67
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Kidney Care PA Nephrology CurrentSince Jul 2, 2001 Accepting new patients

Locations

1745 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 688-0576

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1609972728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-688-0576",
            "fax_number": "863-686-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-688-0576",
            "fax_number": "863-686-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUAYO",
        "first_name": "JOSE",
        "middle_name": "JAVIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME74725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262845700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.