Jacki Marie Deguzman, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15384 Issued in NV

Practice address

10105 Banburry Cross Dr
Suite 150
Las Vegas, NV 89144-6646

Phone

(702) 877-5199

Fax

(702) 854-3259

NPI assigned

Apr 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Medical Group II Rhodes P C 296 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdeguzman119302@westdirect.optum.com
• FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

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.

• Optum Medical Group II Rhodes P C

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1790329407

  Internal Medicine, NV

  Medicare reassignment Care Compare group NPD
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005

  Internal Medicine, NV

  Medicare reassignment NPD
• Optum Medical Group Rhodes P C

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1770556037
  NPD
• De Craig Ranch, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1922542968
  NPD (past)
• Henderson Hospital

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1003281452
  NPD (past)
• North Vista Hospital LLC

  • Psychiatric Hospital Unit
  • North Las Vegas, NV
  • NPI 1619050549
  NPD (past)
• Southern Hills Medical Center, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1457306359
  NPD (past)
• Southwest Medical Associates, Inc

  • Diagnostic Radiology Physician
  • Las Vegas, NV
  • NPI 1679663447
  NPD (past)
• Sunrise Mountainview Hospital, Inc.

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1831143817
  NPD (past)

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1013206614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "address_2": "SUITE 301",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "702-877-5199",
            "fax_number": "702-854-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10105 BANBURRY CROSS DR",
            "address_2": "SUITE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446646",
            "telephone_number": "702-877-5199",
            "fax_number": "702-854-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGUZMAN",
        "first_name": "JACKI",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "15384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01612764",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMA CONVENIENT CARE MEDICARE",
            "identifier": "V108806",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angeleque Robles Deguzman, RBT
• Araceli Deguzman
• Darla Lynn Deguzman
• Dolores Deguzman
• Ericson Deguzman
• Regine Magali Deguzman, PHD
• Jaspreet Dehar, DDS
• Breanna Deherrera
• Rosefay Deighton
• Tessa Deister

• All providers in Las Vegas, NV
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.