MS. LORRAINE SUSAN AGUILAR RNP WHC
NPI 1154406874
Nurse Practitioner - Women's Health in Sacaton, AZ
Quality Rating: 70.7 out of 100 score
NPI Status: Active since October 25, 2006
Contact Information
483 W. SEED FARM RD.
#3
SACATON, AZ
ZIP 85147
Phone: (602) 528-1400
Fax: (602) 528-1402
- Individual
- Female
- Years of Experience 31
- Nurse Practitioner
- Women's Health
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About LORRAINE AGUILAR
This page provides the complete NPI Profile along with additional information for Lorraine Aguilar, a provider established in Sacaton, Arizona with a medical specialization in Nurse Practitioner, focusing in women's health and more than 31 years of experience. The healthcare provider is registered in the NPI registry with number 1154406874 assigned on October 2006. The practitioner's primary taxonomy code is 363LW0102X with license number RN054605 (AZ). The provider is registered as an individual and her NPI record was last updated 10 years ago.
- NPI
- 1154406874
- Provider Name
- MS. LORRAINE SUSAN AGUILAR RNP WHC
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 483 W. SEED FARM RD. #3 SACATON, AZ 85147
- Location Phone
- (602) 528-1400
- Location Fax
- (602) 528-1402
- Mailing Address
- 483 W. SEED FARM RD. #3 SACATON, AZ 85147
- Mailing Phone
- (602) 528-1400
- Mailing Fax
- (602) 528-1402
- Medical School Name
- OTHER
- Graduation Year
- 1995
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-25-2006
- Last Update Date
- 03-20-2015
- Code Navigator
A nurse practitioner (NP) like Lorraine Aguilar is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Women's Health
- Taxonomy Code
- 363LW0102X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- RN054605
- License State
- AZ
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue AdvanceHealth Bronze - Neighborhood Network - HMO
- Blue AdvanceHealth Gold - Neighborhood Network - HMO
- Blue AdvanceHealth Silver - Neighborhood Network - HMO
- Blue EverydayHealth Gold - Neighborhood Network - HMO
- Blue EverydayHealth Silver - Neighborhood Network - HMO
- Blue Portfolio HSA Bronze - Neighborhood Network - HMO
- Blue Portfolio HSA Gold - Statewide PPO Network - PPO
- Blue PPO PremierHealth Silver - Statewide PPO Network - PPO
- Blue PPO PremierHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Gold - Statewide PPO Network - PPO
- Blue PPO StandardHealth Silver - Statewide PPO Network - PPO
- Blue StandardHealth Bronze - Neighborhood Network - HMO
- Blue StandardHealth Gold - Neighborhood Network - HMO
- Blue StandardHealth Silver - Neighborhood Network - HMO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Value ($0 Virtual Urgent Care) - HMO
- UHC Bronze Value+ ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Silver Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
- UHC Silver Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 464470 | MEDICAID (05) | AZ |
Medicare Participation & PECOS Enrollment Status
Lorraine Aguilar is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Lorraine Aguilar is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 9436399417
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20131220000518
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.47 for a new patient copayment and $24.5 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 85147 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $85.89
- Minimum New Patient Price $55.44
- Maximum New Patient Price $168.6
- Average New Patient Copayment $21.47
- Minimum New Patient Copayment $13.86
- Maximum New Patient Copayment $42.15
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $98
- Minimum Established Patient Price $17.72
- Maximum Established Patient Price $137.41
- Average Established Patient Copayment $24.5
- Minimum Established Patient Copayment $4.43
- Maximum Established Patient Copayment $34.35
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 70.7, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 70.7 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 55.25
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: N/A
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 51.05
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 51.05
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Annual registration in the Prescription Drug Monitoring Program | Yes | N/A |
| Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months. | ||
| Consultation of the Prescription Drug Monitoring Program | Yes | N/A |
| Clinicians would attest to reviewing the patients’ history of controlled substance prescription using state prescription drug monitoring program (PDMP) data prior to the issuance of a Controlled Substance Schedule II (CSII) opioid prescription lasting longer than 3 days. For the transition year, clinicians would attest to 60 percent review of applicable patient’s history. For the Quality Payment Program Year 2 and future years, clinicians would attest to 75 percent review of applicable patient’s history performance. | ||
| Depression screening | Yes | N/A |
| Depression screening and follow-up plan: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including depression screening and follow-up plan (refer to NQF #0418) for patients with co-occurring conditions of behavioral or mental health conditions. | ||
| Diabetes: Foot Exam | 39% | 122 |
| The percentage of patients 18-75 years of age with diabetes (type 1 and type 2) who received a foot exam (visual inspection and sensory exam with mono filament and a pulse exam) during the measurement year | ||
| e-Prescribing | 94% | 673 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Health Information Exchange | 22% | 73 |
| The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral. | ||
| Implementation of an ASP | Yes | N/A |
| Change Activity Description to: Leadership of an Antimicrobial Stewardship Program (ASP) that includes implementation of an ASP that measures the appropriate use of antibiotics for several different conditions (such as but not limited to upper respiratory infection treatment in children, diagnosis of pharyngitis, bronchitis treatment in adults) according to clinical guidelines for diagnostics and therapeutics. Specific activities may include: • Develop facility-specific antibiogram and prepare report of findings with specific action plan that aligns with overall facility or practice strategic plan. • Lead the development, implementation, and monitoring of patient care and patient safety protocols for the delivery of ASP including protocols pertaining to the most appropriate setting for such services (i.e., outpatient or inpatient). • Assist in improving ASP service line efficiency and effectiveness by evaluating and recommending improvements in the management structure and workflow of ASP processes. • Manage compliance of the ASP policies and assist with implementation of corrective actions in accordance with facility or clinic compliance policies and hospital medical staff by-laws. • Lead the education and training of professional support staff for the purpose of maintaining an efficient and effective ASP. • Coordinate communications between ASP management and facility or practice personnel regarding activities, services, and operational/clinical protocols to achieve overall compliance and understanding of the ASP. • Assist, at the request of the facility or practice, in preparing for and responding to third-party requests, including but not limited to payer audits, governmental inquiries, and professional inquiries that pertain to the ASP service line. • Implementing and tracking an evidence-based policy or practice aimed at improving antibiotic prescribing practices for high-priority conditions. • Developing and implementing evidence-based protocols and decision-support for diagnosis and treatment of common infections. • Implementing evidence-based protocols that align with recommendations in the Centers for Disease Control and Prevention’s Core Elements of Outpatient Antibiotic Stewardship guidance | ||
| Patient-Specific Education | 63% | 765 |
| The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician. | ||
| Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan | 43% | 460 |
| Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2 | ||
| Preventive Care and Screening: Screening for Depression and Follow-Up Plan | 79% | 544 |
| Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen | ||
| Provide Patient Access | 2% | 767 |
| At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 5 | 4 | 4 | 0 | 6 | 8 | 7 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 10 | 4 | 8 | 0 | 12 | 8 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 0 + 4 + 8 + 0 + 1 + 2 + 8 + 1 + 4 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1154406874 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1801886940 | DR. DARCY JONES O.D. Individual | Optometrist | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1013991728 | CONNIE GIGOUS FNP Individual | Nurse Practitioner (Family) | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1730164054 | DR. NOEL D. HABIB M.D. Individual | Obstetrics & Gynecology | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1033195524 | DR. MONICA A LUMPKIN M.D. Individual | Family Medicine | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1891771135 | MS. PATRICIA A THUNDERCLOUD PA-C Individual | Physician Assistant | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1659341865 | DR. PETER C WAGNER D.O. Individual | Family Medicine | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1265492433 | EDWIN MGBAM MD Individual | Internal Medicine | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1588775498 | DR. ROGER F VILLALBA MD Individual | Family Medicine | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1427131911 | DR. EVA JENNER DDS Individual | Dentist (General Practice) | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1770669939 | DR. JODY B HERSCHENHORN-DOMINICK DDS Individual | Dentist (General Practice) | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1699971739 | KEVIN LYNN HELMUTH O.D. Individual | Optometrist | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1033437884 | GILA RIVER HEALTH CARE CORPORTION Organization | General Acute Care Hospital (Critical Access) | 483 W. SEED FARM RD. CREDENTIALING SACATON, AZ 85147 (602) 528-1340 |
| 1811200157 | MS. LOUISA J SZAREK REGISTERED DIETITION Individual | Dietitian, Registered | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1340 |
| 1528371317 | MS. HEATHER MARIE JOSEPH REGISTERED DIETITIAN Individual | Dietitian, Registered | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1340 |
| 1215214473 | CAROLE A LOVE LISAC Individual | Counselor | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1205113461 | DARIN C UHRICH LISAC Individual | Counselor | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1770860934 | ARLENE S ALLISON LISAC Individual | Counselor | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1689951840 | DAVID L PEWE LISAC Individual | Counselor | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1124397575 | ERIC M CAMPBELL P.A.-C Individual | Physician Assistant | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
| 1316205214 | MELVA L. ZERKOUNE R.D. Individual | Dietitian, Registered | 483 W. SEED FARM RD. SACATON, AZ 85147 (602) 528-1200 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154406874, enumerated in the NPI registry as an "individual" on October 25, 2006
The provider is located at 483 W. Seed Farm Rd. #3 Sacaton, Az 85147 and the phone number is (602) 528-1400
The provider's speciality is Nurse Practitioner with taxonomy code 363LW0102X with a focus in Women's Health
The provider has more than 31 years of experience.
The provider might be accepting Accepts: Blue Cross Blue Shield of Arizona,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $85.89 with an average copayment of $21.47 for new patient appointments. Established patients should expect a typical charge of $98 and an average copayment of 24.5. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on October 25, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.