NPIMap

Organization Active NPI

AIDS Arms, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dallas, TX
National Provider Identifier
1770314296
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AIDS ARMS, INC.
Practice address
4922 Spring Ave
Dallas, TX 75210-1359
Phone
(214) 421-7488
Fax
(214) 421-1119
NPI assigned
Aug 8, 2024
Organization subpart
Yes
Parent organization
AIDS ARMS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Authorized official

Name
Michael Anthony Aguilar
Title
Senior Director Revenue Cycle
Phone
(512) 684-3751

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

4922 Spring Ave
Dallas, TX 75210-1359

Mailing address

3900 Junius St Ste 300
Dallas, TX 75246-1602
Phone (214) 623-6897

Other names 1

  • PRISM HEALTH NORTH TEXAS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241016000478 TX Part A Provider - Federally Qualified Health Center (FQHC) 7719940774 Practice locations: Dallas, TX

Federally qualified health center certification: CCN 971024

Legal name
AIDS ARMS, INC.
Doing business as
PRISM HEALTH NORTH TEXAS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 15, 2024
Last certification
Oct 15, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4922 Spring Ave
Dallas, TX 75210-1359

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
AIDS Arms Inc13 organizations share this tax ID, including this one
Part of
AIDS Arms Inc

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John T Carlo Individual W-2 Managing EmployeeCeo Aug 1, 2024
Michael a Aguilar Individual W-2 Managing EmployeeSenior Director of Revenue Cycle Aug 1, 2024
Terri Kimmell Individual W-2 Managing EmployeeCredentialing Manager Aug 1, 2024

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1770314296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST STE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461602",
            "telephone_number": "214-623-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4922 SPRING AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752101359",
            "telephone_number": "214-421-7488",
            "fax_number": "214-421-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIDS ARMS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AIDS ARMS, INC.",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "AGUILAR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "512-684-3751"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRISM HEALTH NORTH TEXAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.