Individual provider Active NPI

Aaron Jimenez Duque, RN

  • Peritoneal Dialysis Registered Nurse
  • Chula Vista, CA
National Provider Identifier
1982242244
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peritoneal Dialysis Registered NurseTaxonomy code 163WD1100X
License
95070652 Issued in CA
Practice address
2391 Boswell Rd
Chula Vista, CA 91914-3509
Phone
(619) 397-0939
Fax
(619) 421-4907
NPI assigned
Dec 18, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 95070652 CA
Rehabilitation Registered Nurse 163WR0400X 95070652 CA
Peritoneal Dialysis Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WD1100X 95070652 CA Primary

Addresses

Primary practice location

2391 Boswell Rd
Chula Vista, CA 91914-3509

Mailing address

911 Via Verde
Chula Vista, CA 91910-7025
Phone (619) 502-1456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95070652CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fresenius Medical Care East Lakes, LLC CurrentSince Dec 27, 2020 Accepting new patients

Locations

2391 Boswell Rd
Chula Vista, CA 91914
Phone (619) 397-0939

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1982242244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 VIA VERDE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107025",
            "telephone_number": "619-502-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2391 BOSWELL RD",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143509",
            "telephone_number": "619-397-0939",
            "fax_number": "619-421-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUQUE",
        "first_name": "AARON",
        "middle_name": "JIMENEZ",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-18",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "95070652",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "CA",
            "license": "95070652",
            "primary": false
        },
        {
            "code": "163WD1100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Dialysis, Peritoneal",
            "state": "CA",
            "license": "95070652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.