Individual provider Active NPI

Rocio Dominguez Aguilar, MHSC, PA-C

  • Physician Assistant
  • Merritt Island, FL
National Provider Identifier
1679357701
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9117750 Issued in FL
Practice address
390 N Courtenay Pkwy
Merritt Island, FL 32953-3456
Phone
(321) 633-3162
Fax
(321) 821-4955
NPI assigned
Aug 21, 2023
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9117750 FL Primary

Addresses

Primary practice location

390 N Courtenay Pkwy
Merritt Island, FL 32953-3456

Mailing address

14412 SW 46TH Ter
Miami, FL 33175-6834
Phone (786) 245-9446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231005002191 FL Practitioner - Physician Assistant 3678928959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medfast Urgent Care Centers LLCGroup PAC ID 1052418837, 73 clinicians

Practice addresses (Care Compare)

206 E New Haven Ave
Melbourne, FL 32901-4504
Phone (321) 802-3311

2330 N Wickham Rd
Suite 12
Melbourne, FL 32935-8184
Phone (321) 633-3278

5005 Port St John Pkwy
Port St John, FL 32927-4305
Phone (321) 757-7222

820 Palm Bay Rd NE
Suite 110
Palm Bay, FL 32905-6351
Phone (321) 633-3278

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medfast Urgent Care Centers, LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

7970 N Wickham Rd
Melbourne, FL 32940
Phone (321) 255-7711

390 N Courtenay Pkwy
Merritt Island, FL 32953
Phone (321) 633-3162

5005 Port St John Pkwy
Port St John, FL 32927
Phone (321) 504-0556

Networks

  • Freedom Health HMO Network

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": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1679357701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14412 SW 46TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331756834",
            "telephone_number": "786-245-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533456",
            "telephone_number": "321-633-3162",
            "fax_number": "321-821-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ AGUILAR",
        "first_name": "ROCIO",
        "credential": "MHSC, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9117750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.