Physician Compare National (NPI:1568463792)

HEALTHCARE PROVIDER: RUBEN AGUILERA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1568463792
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901792951
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080910000195
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AGUILERA
	Individual professional last name
Provider First Name	RUBEN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	BAYLOR COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	13943 N 91ST AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	BLDG E
	Group Practice or individual's line 2 address
City	PEORIA
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	853813629
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	030061
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BANNER BOSWELL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	030014
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HONORHEALTH JOHN C LINCOLN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y