Individual provider Active NPI

Laura Kay-Aguilar Houck, PA-C

  • Physician Assistant
  • Redlands, CA
National Provider Identifier
1780871400
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19399 Issued in CA
Practice address
16 E Fern Ave
Redlands, CA 92373-4000
Phone
(909) 435-4852
NPI assigned
Sep 26, 2007
Last updated
Aug 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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 PA19399 CA Primary

Addresses

Primary practice location

16 E Fern Ave
Redlands, CA 92373-4000

Mailing address

PO Box 8548
Redlands, CA 92375-1748

Other identifiers 3

IdentifierTypeStateIssuer
56571526MedicaidCO
58080881MedicaidNM
282677MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080529000335 CA Practitioner - Physician Assistant 4587746292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medamerica Physician Solutions PCGroup PAC ID 8729221809, 28 clinicians

Practice addresses (Care Compare)

11340 Mountain View Ave
Suite B
Loma Linda, CA 92354-3858
Phone (909) 435-4852

16 E Fern Ave
Suite B
Redlands, CA 92373-4000
Phone (909) 435-4852

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA19399CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Redlands Community Hospital Past Accepting new patients
Brockton Podiatry Group a Prof Corp PastSince Feb 9, 2009 Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: laura.houck.1@20515.direct.athenahealth.com

Organizations & group practices 3

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": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1780871400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8548",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923751748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 E FERN AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734000",
            "telephone_number": "909-435-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUCK",
        "first_name": "LAURA",
        "middle_name": "KAY-AGUILAR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA19399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56571526",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58080881",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282677",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.