Ted Ubina Pagulayan, FNP-BC, APHN-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

30297876 Issued in DC

Practice address

1 Wahoo Ave
Groton, CT 06340-2324

Phone

(860) 694-7512

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1689654394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CRYSTAL AVE",
            "address_2": "UNIT # 5",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206500",
            "telephone_number": "703-618-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WAHOO AVE",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402324",
            "telephone_number": "860-694-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGULAYAN",
        "first_name": "TED",
        "middle_name": "UBINA",
        "name_prefix": "Mr.",
        "credential": "FNP-BC, APHN-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "VA",
            "license": "0001169726",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "30297876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optics Unlimited
• Rogelio Antonio Oria
• Christopher Robert Ortiz, D.M.D.
• Deborah Otka
• Matthew G Ouzts, IDC
• Randy L Panke, NCCPA
• Karen Lee Parkinson, LCSW
• Nimesh K Patel, D.O.
• Katherine Anne Pearce, DPT
• Bobbi Peck, RBT

• Family Nurse Practitioner in Groton, CT
• Providers in Groton, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.