Individual provider Active NPI

Christian Aguilar, PA-C, RDN

  • Physician Assistant
  • Willimantic, CT
National Provider Identifier
1902659337
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
49 Gifford Ave
Willimantic, CT 06226-3425
Phone
(860) 634-1821
NPI assigned
Apr 8, 2024
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20241216003400 CT Practitioner - Physician Assistant 4789110677 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Boston Wellness Primary Care PC Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

49 Gifford Ave
Willimantic, CT 06226-3425

Mailing address

49 Gifford Ave
Willimantic, CT 06226-3425
Phone (860) 634-1821

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 9, 2024.

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1902659337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 GIFFORD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263425",
            "telephone_number": "860-634-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 GIFFORD AVE",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263425",
            "telephone_number": "860-634-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILAR",
        "first_name": "CHRISTIAN",
        "credential": "PA-C, RDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.