Caroline Marie Licud Aventura, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A102553 Issued in CA

Practice address

1300 S Sunset Ave
West Covina, CA 91790-3342

Phone

(626) 338-9915

NPI assigned

May 1, 2007

Last updated

Jul 24, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Systems IncGroup PAC ID 7012824717, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: caroline.aventuramd.p1@direct.chsica.nextgenshare.com

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.

• Community Health Systems Inc

  dba Fallbrook Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Fallbrook, CA
  • NPI 1982756086

  Family Medicine

  Care Compare group NPD
• Community Health Systems, Inc.

  dba Inland Empire Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bloomington, CA
  • NPI 1952308009
  Medicare reassignment
• Community Health Systems, Inc.

  dba Bloomington Wellness Pharmacy

  • Community/Retail Pharmacy
  • Bloomington, CA
  • NPI 1215684063
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406160000000",
    "number": "1962623538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 CAMFIELD AVE",
            "city": "COMMERCE",
            "state": "CA",
            "postal_code": "900401502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903342",
            "telephone_number": "626-338-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVENTURA",
        "first_name": "CAROLINE",
        "middle_name": "MARIE LICUD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2014-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301084039",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A102553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE PTAN",
            "identifier": "W14158",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE PTAN",
            "identifier": "ZZZ20041Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Wai Aung, D.D.S.
• Avalon Angels Nursing & Caregiver Services, Inc.
• Monique Avendano
• Alla Alexandra Avetisyan, HIS
• Michael Aviado
• Serena Noelani Avila-Cortes, DO
• Yasmin Avila
• Serena Maria Avilez, LCSW

• Family Medicine Physician in West Covina, CA
• Providers in West Covina, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.