Individual provider Active NPI

Maria Socorro Agorrilla, FNP

  • Family Nurse Practitioner
  • Temecula, CA
National Provider Identifier
1659775708
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95001560 Issued in CA
Practice address
44274 George Cushman CT Ste 212
Temecula, CA 92592-5945
Phone
(951) 694-4688
Fax
(888) 827-3492
NPI assigned
Oct 18, 2014
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95001560 CA Primary

Addresses

Primary practice location

44274 George Cushman CT Ste 212
Temecula, CA 92592-5945

Mailing address

1545 W Florida Ave
Hemet, CA 92543-3814
Phone (951) 791-1111

Other practice location 1

31736 Mission Trl Ste G
Lake Elsinore, CA 92530-4533
Phone (951) 674-1505

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
I20160525002757 CA Practitioner - Nurse Practitioner 9537462155 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95001560CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gi Excellence Inc CurrentSince Jan 5, 2019 Accepting new patients
Menifee Global Multi-Specialty Group Inc PastSince May 1, 2015 Accepting new patients

Locations

1003 E Florida Ave
Ste 101
Hemet, CA 92543
Phone (310) 990-3461

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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": "1413590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1659775708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 W FLORIDA AVE",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925433814",
            "telephone_number": "951-791-1111",
            "fax_number": "888-856-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44274 GEORGE CUSHMAN CT STE 212",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925945",
            "telephone_number": "951-694-4688",
            "fax_number": "888-827-3492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31736 Mission Trl Ste G",
            "address_purpose": "LOCATION",
            "city": "Lake Elsinore",
            "state": "CA",
            "postal_code": "925304533",
            "country_code": "US",
            "telephone_number": "951-674-1505",
            "fax_number": "951-245-6397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGORRILLA",
        "first_name": "MARIA",
        "middle_name": "SOCORRO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-18",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95001560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.