Individual provider Active NPI

Michael Aquitania Agbisit, ACNPC-AG

  • Acute Care Nurse Practitioner
  • San Jacinto, CA
National Provider Identifier
1619415528
Registry record updated Feb 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95006150 Issued in CA
Practice address
448 Oriole Rd
San Jacinto, CA 92582-6965
Phone
(951) 654-8038
NPI assigned
Feb 10, 2017
Last updated
Feb 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 95006150 CA Primary

Addresses

Primary practice location

448 Oriole Rd
San Jacinto, CA 92582-6965

Mailing address

448 Oriole Rd
San Jacinto, CA 92582-6965
Phone (951) 654-8038

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170505001572 CA Practitioner - Nurse Practitioner 7315224094 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trucare Medical Corporation CurrentSince Jun 1, 2020 Accepting new patients
Desert Medical Group, Inc. CurrentSince Mar 3, 2025 Accepting new patients
Apex Emergency Medical Group, Inc. CurrentSince Apr 1, 2017 Accepting new patients
Kolli Medical Corporation CurrentSince Oct 1, 2021 Accepting new patients
Hemchand Kolli, MD Inc CurrentSince Feb 29, 2020 Accepting new patients

Locations

3400 W Ball Rd
Ste 100A
Anaheim, CA 92804
Phone (714) 995-1098

1117 E Devonshire Ave
Hemet, CA 92543
Phone (951) 652-2811

1278 E Latham Ave
Hemet, CA 92543
Phone (951) 925-6625

1600 E Florida Ave
Ste 103
Hemet, CA 92544
Phone (951) 925-6625

1234 W Chapman Ave
Ste 101
Orange, CA 92868
Phone (714) 223-0883

2601 E Chapman Ave
Orange, CA 92869
Phone (714) 633-0011

275 N El Cielo Rd
Palm Springs, CA 92262
Phone (760) 320-8814

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: magbisit254182@direct.llu.edu
  • Direct secure messaging: michael.agbisit.p2@direct.mydohc.nextgenshare.com
  • Direct secure messaging: michael.agbisit.p22@direct.kmsm.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1619415528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 ORIOLE RD",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925826965",
            "telephone_number": "951-654-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 ORIOLE RD",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925826965",
            "telephone_number": "951-654-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGBISIT",
        "first_name": "MICHAEL",
        "middle_name": "AQUITANIA",
        "credential": "ACNPC-AG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-10",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95006150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jacinto, CA

Sources for this page

Verify at the official NPI Registry.