Individual provider Active NPI

Stacey Guerrera, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1023168077
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051629 Issued in PA
Practice address
51 N 39TH St
4 Phi
Philadelphia, PA 19104-2640
Phone
(215) 662-9189
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051629 PA Primary

Addresses

Primary practice location

51 N 39TH St
4 Phi
Philadelphia, PA 19104-2640

Mailing address

51 N 39TH St
4 Phi
Philadelphia, PA 19104-2640
Phone (215) 662-9189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040618000995 PA Practitioner - Physician Assistant 6406831171 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1338 Bristol Pike
Suite 100
Bensalem, PA 19020-5679
Phone (215) 447-1430

51 N 39TH St 4 HVP
Penn Cardiology Penn Presbyterian 4TH Floor
Philadelphia, PA 19104-2640
Phone (215) 662-9189

7133 Roosevelt Blvd
Philadelphia, PA 19149-1431
Phone (215) 333-5604

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Health Care Associates of New Jersey, PC CurrentSince Aug 29, 2017 Accepting new patients
Clinical Health Care Associates of New Jersey, P.C. CurrentSince Aug 29, 2017 Accepting new patients

Locations

51 N 39th St
Fl 4
Philadelphia, PA 19104
Phone (215) 662-9189

51 N 39th St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-9010

7133 Roosevelt Blvd
Philadelphia, PA 19149
Phone (215) 333-3311

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1023168077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "4 PHI",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N 39TH ST",
            "address_2": "4 PHI",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191042640",
            "telephone_number": "215-662-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERA",
        "first_name": "STACEY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.