Demetrio J Agcaoili MD LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

35083354 Issued in OH

Legal business name

DEMETRIO J AGCAOILI MD LLC

Practice address

51520 National Road E
Suite 5
Saintclairsville, OH 43950-8213

Phone

(740) 296-5931

Fax

(740) 296-5942

NPI assigned

Nov 9, 2006

Organization subpart

No

Name

Demetrio Jose Agcaoili, M.D.NPI 1124040951

Title

Owner

Phone

(740) 695-3703

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Demetrio J. Agcaoili, M.D.

  • Infectious Disease Physician
  • Saint Clarisville, OH
  • NPI 1124040951

  OH, WV

  Medicare reassignment Authorized official
• Gina Marie Cappiccie, FNP-BC

  • Family Nurse Practitioner
  • Charles Town, WV
  • NPI 1144818907

  WV

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in WV, OH2 enrollments

Enrollment records 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 23, 2020.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1679643183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51520 NATIONAL ROAD E",
            "address_2": "SUITE 5",
            "city": "SAINTCLAIRSVILLE",
            "state": "OH",
            "postal_code": "439508213",
            "telephone_number": "740-296-5931",
            "fax_number": "740-296-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51520 NATIONAL ROAD E",
            "address_2": "SUITE 5",
            "city": "SAINTCLAIRSVILLE",
            "state": "OH",
            "postal_code": "439508213",
            "telephone_number": "740-296-5931",
            "fax_number": "740-296-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMETRIO J AGCAOILI MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "AGCAOILI",
        "authorized_official_first_name": "DEMETRIO",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "740-695-3703",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "OH",
            "license": "35083354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841957000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2413267",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.