Individual provider Active NPI

Aurelio Tony Aguirre

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1639299647
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15565 Issued in CA
Practice address
1530 S Olive St
Los Angeles, CA 90015-3023
Phone
(213) 747-5542
Fax
(213) 746-9379
NPI assigned
Mar 31, 2007
Last updated
Apr 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA15565 CA
Obstetrics & Gynecology Physician 207V00000X PA15565 CA
Physician Assistant 363A00000X PA15565 CA Primary

Addresses

Primary practice location

1530 S Olive St
Los Angeles, CA 90015-3023

Mailing address

1936 E Anaheim St
Long Beach, CA 90813-3908
Phone (562) 599-2248

Other practice location 1

1936 E Anaheim St
Long Beach, CA 90813-3908
Phone (562) 599-2248

Other identifiers 1

IdentifierTypeStateIssuer
PA15565MedicaidCA

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
I20100722001028 CA Practitioner - Physician Assistant 9830221076 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15565CAMDAcupuncturist
PA15565CAMDPhysician Assistant

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: aurelio.aguirre.1@28334.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1639299647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133908",
            "telephone_number": "562-599-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 S OLIVE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153023",
            "telephone_number": "213-747-5542",
            "fax_number": "213-746-9379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1936 E Anaheim St",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908133908",
            "country_code": "US",
            "telephone_number": "562-599-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGUIRRE",
        "first_name": "AURELIO",
        "middle_name": "TONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-31",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA15565",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "PA15565",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA15565",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.