Active NPI
Jaime Aguilar, PAC
- Physician Assistant
- Eagle Butte, SD
National Provider Identifier
1962552398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0491
- Practice address
- 317 Main Street
Eagle Butte, SD 57625-0910 - Phone
- (605) 964-3007
- Fax
- (605) 964-1139
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0491 | SD | Primary |
Addresses
Primary practice location
317 Main Street
Eagle Butte, SD 57625-0910
Mailing address
PO Box 910
Eagle Butte, SD 57625-0910
Phone (605) 964-7575
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962552398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 910",
"city": "EAGLE BUTTE",
"state": "SD",
"postal_code": "576250910",
"telephone_number": "605-964-7575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 MAIN STREET",
"city": "EAGLE BUTTE",
"state": "SD",
"postal_code": "576250910",
"telephone_number": "605-964-3007",
"fax_number": "605-964-1139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGUILAR",
"first_name": "JAIME",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "SD",
"license": "0491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagle Butte, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.