Agusti Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01061624A Issued in IN

Legal business name

AGUSTI MEDICAL CORPORATION

Practice address

4900 E 107TH CT
Winfield, IN 46307-2862

Phone

(219) 386-5018

Fax

(219) 472-0089

NPI assigned

Jul 2, 2009

Last updated

Dec 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jose L Agusti, MDNPI 1033192604

Title

President

Phone

(219) 900-3990

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jose Luis Agusti, M.D.

  • Internal Medicine Physician
  • Winfield, IN
  • NPI 1033192604
  Medicare reassignment NPD Authorized official
• Lori Ann Morrow, NP-C

  • Family Nurse Practitioner
  • Saint John, IN
  • NPI 1942587449
  NPD (past)
• Doreen Lynn Zokvic, MS, RN, CNS, AGACNP

  • Acute Care Nurse Practitioner
  • San Tan Valley, AZ
  • NPI 1447552153
  NPD (past)

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1861621575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 E 107TH CT",
            "city": "WINFIELD",
            "state": "IN",
            "postal_code": "463072862",
            "telephone_number": "219-900-3990",
            "fax_number": "219-472-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 E 107TH CT",
            "city": "WINFIELD",
            "state": "IN",
            "postal_code": "463072862",
            "telephone_number": "219-386-5018",
            "fax_number": "219-472-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGUSTI MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-02",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "AGUSTI",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-900-3990",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01061624A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00778872,DP6718",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200832510",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200967510A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Luis Agusti, M.D.
• Apc Holdings LLC (Fast Pace Health Case Management)
• Sarah Camel
• Stacy A Fredrickson, PT, DPT
• Nicole Gilbert, PT

• Internal Medicine Physician in Winfield, IN
• Providers in Winfield, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.