Individual provider Active NPI

Isaac Cuauhcoatl Aguilar

  • Physical Therapy Clinic/Center
  • Tacoma, WA
National Provider Identifier
1659969574
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
61092959 Issued in WA
Practice address
3315 S 23Rd St Ste 210
Tacoma, WA 98405-1616
Phone
(253) 572-8684
NPI assigned
Jan 6, 2021
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220323001098 CA Practitioner - Physical Therapist in Private Practice 5799199899 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61092959WAMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Hospital Physical Therapy Current Accepting new patients
Orthopaedic Hospital Medical Group Inc Physical Therapy CurrentSince Mar 1, 2022 Accepting new patients

Locations

403 W Adams Blvd
Los Angeles, CA 90007
Phone (213) 741-8330

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 61092959 WA Primary

Addresses

NPPES NPI Registry

Primary practice location

3315 S 23Rd St Ste 210
Tacoma, WA 98405-1616

Mailing address

2701 N 12TH St Unit B
Tacoma, WA 98406-7316
Phone (323) 839-7150

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 6, 2021.

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1659969574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N 12TH ST UNIT B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984067316",
            "telephone_number": "323-839-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 S 23RD ST STE 210",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051616",
            "telephone_number": "253-572-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "ISAAC",
        "middle_name": "CUAUHCOATL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "WA",
            "license": "61092959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.