Individual provider Active NPI

Eugenio Moises Guevara, M.D.

  • Neurology Physician
  • Hialeah, FL
National Provider Identifier
1033305701
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME108468 Issued in FL
Practice address
777 E 25TH St Ste 319
Hialeah, FL 33013-3849
Phone
(305) 693-8585
Fax
(305) 693-8595
NPI assigned
Sep 17, 2007
Last updated
Apr 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME108468 FL Primary
Interventional Pain Medicine Physician 208VP0014X ME108468 FL

Addresses

Primary practice location

777 E 25TH St Ste 319
Hialeah, FL 33013-3849

Mailing address

777 E 25TH St Ste 319
Hialeah, FL 33013-3849
Phone (305) 693-8585

Other identifiers 1

IdentifierTypeStateIssuer
004468000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20110809000746 FL Practitioner - NeurologyPractitioner - Pain ManagementPractitioner - PsychiatryPractitioner - Interventional Pain Management 5597802371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pain Management, Psychiatry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

777 E 25TH St
Suite 319
Hialeah, FL 33013-3849
Phone (305) 693-8585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Eugenio Moises Guevara MD PA Neurology Current Accepting new patients
Eugenio Moises Guevara MD PA Neurology CurrentSince Jan 24, 2012 Accepting new patients
Pma Medical Treatment Centers, LLC PastSince Jan 1, 2016 Accepting new patients

Locations

777 E 25th St
Ste 319
Hialeah, FL 33013
Phone (305) 447-6688

9220 Sunset Dr
Ste 206
Miami, FL 33173
Phone (305) 285-6993

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1033305701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 319",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133849",
            "telephone_number": "305-693-8585",
            "fax_number": "305-693-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 319",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133849",
            "telephone_number": "305-693-8585",
            "fax_number": "305-693-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "EUGENIO",
        "middle_name": "MOISES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-17",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME108468",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME108468",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004468000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.