Individual provider Active NPI

Wilbert Aguila, P.T.

  • Physical Therapist
  • Fairfax, VA
National Provider Identifier
1861776551
Registry record updated Oct 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305207374 Issued in VA
Practice address
12678 Marcum CT
Fairfax, VA 22033-2457
Phone
(516) 342-0907
NPI assigned
Sep 29, 2011
Last updated
Oct 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 026932 NY
Physical Therapist 225100000X 2305207374 VA Primary

Addresses

Primary practice location

12678 Marcum CT
Fairfax, VA 22033-2457

Mailing address

12678 Marcum CT
Fairfax, VA 22033-2457
Phone (516) 342-0907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305207374VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475366400000",
    "number": "1861776551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12678 MARCUM CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332457",
            "telephone_number": "516-342-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12678 MARCUM CT",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332457",
            "telephone_number": "516-342-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILA",
        "first_name": "WILBERT",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-29",
        "last_updated": "2016-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "026932",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305207374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.