Michelle Ileana Aguilar, MD
Individual provider Active NPI Pediatrics Physician · Venice, CA
NPI 1992021810 · NPPES record last updated Mar 4, 2021
Key facts
- NPI
- 1992021810
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- A118876 (CA)
- Practice address
- 604 Rose Ave
Venice, CA 90291-2767 - Phone
- (310) 392-8636
- NPI assigned
- Apr 16, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130509000483 | CA | Practitioner - Pediatric Medicine | 3678710704 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A118876 | CA | MD | Pediatrics Physician |
Practice roles (5 of 6)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Venice Family Clinic | Current | Accepting new patients | |
| Venice Family Clinic | Current |
Accepting new patients | |
| Venice Family Clinic | Current | Accepting new patients | |
| Venice Family Clinic | Current | Accepting new patients | |
| Venice Family Clinic | Current |
Accepting new patients |
Locations
4700 Inglewood Blvd
Ste 102
Los Angeles, CA 90230
Phone (310) 664-7901
2509 Pico Blvd
Santa Monica, CA 90405
Phone (310) 664-7901
604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630
905 Venice Blvd
Venice, CA 90291
Phone (310) 392-8630
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- maguilar753159@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | A118876 | CA | Yes |
Addresses
Primary practice location
604 Rose Ave
Venice, CA 90291-2767
Mailing address
604 Rose Ave
Venice, CA 90291-2767
Phone (310) 392-8636
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | michelle.aguilar.p1@direct.venicefamilyclinic.nextgenshare.com | Direct |
Other providers in Venice, CA
- Ashley C Adams
- Zamilah Adomaityte
- Advanced Chiropractic & Spinal Rehab.
- Asha Elizabeth Agarwal
- Patricio Angelo Agbagala
- Valerie R Aguilar
- Nina Alabdulrazzaq
- Rachel Elizabeth Alaofin
- Mayra Sarahi Alcantar
- Judy Alexander
All providers in Venice, CA · Pediatrics Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.