NPIMap

Individual provider Active NPI

Agustin Jaime Lara, M.D.

  • Family Medicine Physician
  • Ventura, CA
National Provider Identifier
1962697219
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A97569 Issued in CA
Practice address
138 W Main St Ste E
Ventura, CA 93001-2584
Phone
(805) 667-2850
NPI assigned
Sep 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A97569 CA Primary

Addresses

Primary practice location

138 W Main St Ste E
Ventura, CA 93001-2584

Mailing address

5855 Olivas Park Dr Ste a
Ventura, CA 93003-7672
Phone (805) 667-2801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090806000235 CA Practitioner - Family Practice 1355494477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Francisco School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

138 W Main St
Suite E
Ventura, CA 93001-2584
Phone (805) 667-2850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A97569CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System CurrentSince Mar 1, 2019 Accepting new patients
Community Memorial Health System Current Accepting new patients
Community Memorial Health System CurrentSince Mar 1, 2019 Accepting new patients
Community Memorial Healthcare, Inc. Past Accepting new patients
White Memorial Medical Center Past Accepting new patients
Fresno Community Hospital and Medical Center Past Accepting new patients

Locations

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

138 W Main St
Ventura, CA 93001
Phone (805) 667-2850

5855 Olivas Park Dr
Ste A
Ventura, CA 93003

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

Interoperability endpoints

  • Direct secure messaging: agustinlara@cfh.allscriptsdirect.net
  • Direct secure messaging: alara3518221@oc.providencedirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1962697219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 OLIVAS PARK DR STE A",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930037672",
            "telephone_number": "805-667-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W MAIN ST STE E",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930012584",
            "telephone_number": "805-667-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "AGUSTIN",
        "middle_name": "JAIME",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A97569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.