Individual provider Active NPI

Theresa Aqui, NP-C

  • Gerontology Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1912475542
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95010322 Issued in CA
Practice address
7801 Mission Center CT
San Diego, CA 92108-1313
Phone
(619) 738-5566
NPI assigned
Nov 13, 2018
Last updated
Nov 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95010322 CA Primary

Addresses

Primary practice location

7801 Mission Center CT
San Diego, CA 92108-1313

Mailing address

7801 Mission Center CT
San Diego, CA 92108-1313
Phone (619) 738-5566

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
I20190708000785 CA Practitioner - Nurse Practitioner 0840525226 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pouya Afshar MD IncGroup PAC ID 1557656337, 19 clinicians

Practice addresses (Care Compare)

7801 Mission Ctr CT
Suite 310
San Diego, CA 92108-1316
Phone (619) 738-5566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95010322CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pouya Afshar MD Inc CurrentSince May 27, 2019 Accepting new patients
Iha Pulmonary Inc Past Accepting new patients

Locations

3111 Camino del Rio N
Ste 625
San Diego, CA 92108
Phone (619) 738-5566

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, 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": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1912475542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 MISSION CENTER CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081313",
            "telephone_number": "619-738-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 MISSION CENTER CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081313",
            "telephone_number": "619-738-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AQUI",
        "first_name": "THERESA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95010322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.