Agusti Medical Corporation | |
4900 E 107th Ct Winfield IN 46307-2862 | |
(219) 386-5018 | |
(219) 472-0089 |
Full Name | Agusti Medical Corporation |
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Speciality | Internal Medicine |
Location | 4900 E 107th Ct, Winfield, Indiana |
Authorized Official Name and Position | Jose L Agusti (PRESIDENT) |
Authorized Official Contact | 2199003990 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Agusti Medical Corporation 4900 E 107th Ct Winfield IN 46307-2862 Ph: (219) 900-3990 | Agusti Medical Corporation 4900 E 107th Ct Winfield IN 46307-2862 Ph: (219) 386-5018 |
NPI Number | 1861621575 |
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Provider Enumeration Date | 07/02/2009 |
Last Update Date | 12/27/2023 |
Medicare PECOS PAC ID | 0749334019 |
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Medicare Enrollment ID | O20090820000648 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861621575 | NPI | - | NPPES |
200832510 | Medicaid | IN | |
200967510A | Medicaid | IN | |
P00778872,DP6718 | Other | IN | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 01061624A (Indiana) | Primary |
Provider Name | Jose L Agusti |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1033192604 PECOS PAC ID: 4688569122 Enrollment ID: I20060724000077 |
Provider Name | Chelsea Mitchell |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053924381 PECOS PAC ID: 5496175614 Enrollment ID: I20201008003106 |
Provider Name | Rosario Meza |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912695362 PECOS PAC ID: 0749646560 Enrollment ID: I20230522002069 |