Individual provider Active NPI

Madelaine Mabunga Aquino, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Stockton, CA
National Provider Identifier
1841379856
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A85500 Issued in CA
Practice address
10200 Trinity Pkwy
Suite 207
Stockton, CA 95219-7286
Phone
(209) 943-6740
Fax
(209) 943-6744
NPI assigned
Nov 2, 2006
Last updated
Apr 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A85500 CA Primary

Addresses

Primary practice location

10200 Trinity Pkwy
Suite 207
Stockton, CA 95219-7286

Mailing address

10200 Trinity Pkwy
Suite 207
Stockton, CA 95219-7286
Phone (209) 943-6740

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040722000852 CA Practitioner - Physical Medicine and Rehabilitation 5890779151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10200 Trinity Pkwy
Suite 207
Stockton, CA 95219-7288
Phone (209) 943-6740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A85500CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Madelaine Aquino, M.D. Inc. CurrentSince Jul 7, 2004 Accepting new patients
Clinton Back & Neck Care Center Past Accepting new patients
Doctors Hospital of Manteca, Inc. PastSince Jul 7, 2004 Accepting new patients

Locations

10200 Trinity Pkwy
Ste 207
Stockton, CA 95219
Phone (209) 943-6740

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366329600000",
    "number": "1841379856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 TRINITY PKWY",
            "address_2": "SUITE 207",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197286",
            "telephone_number": "209-943-6740",
            "fax_number": "209-943-6744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 TRINITY PKWY",
            "address_2": "SUITE 207",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952197286",
            "telephone_number": "209-943-6740",
            "fax_number": "209-943-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUINO",
        "first_name": "MADELAINE",
        "middle_name": "MABUNGA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2013-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A85500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.