Individual provider Active NPI

Riley Guest

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1033885256
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4777 E Outer Dr
Detroit, MI 48234-3241
Phone
(313) 369-9100
NPI assigned
Aug 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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 Primary

Addresses

Primary practice location

4777 E Outer Dr
Detroit, MI 48234-3241

Mailing address

4700 Dixon Cavett Rd
Convoy, OH 45832-9501
Phone (419) 513-0102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20230811000220 OH Practitioner - Physician Assistant 3072919398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hocking Valley Medical Group, Inc.Group PAC ID 0345238622, 21 clinicians
Central Ohio Urology Group, LLC.Group PAC ID 5395758882, 48 clinicians

Practice addresses (Care Compare)

541 State Route 664 N
Logan, OH 43138-8541
Phone (740) 380-8350

601 State Route 664 N
Logan, OH 43138-8541
Phone (740) 380-8129

701 Tech Ctr Dr
Gahanna, OH 43230-1987
Phone (614) 396-2684

819 State Route 664 N
Logan, OH 43138-8540
Phone (740) 380-8140

8200 Hazelton-Etna Rd
Suite 200
Pastaskala, OH 43062
Phone (800) 720-0505

Hospital & facility affiliations

  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Hocking Valley Community Hospital Hospital, Logan, OH, CCN 361330
  • Holzer Medical Center Hospital, Gallipolis, OH, CCN 360054
  • Fairfield Medical Center Hospital, Lancaster, OH, CCN 360072

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Ohio Urology Group, LLC CurrentSince Jul 3, 2023 Accepting new patients
Hocking Valley Medical Group Transportation CurrentSince Oct 14, 2023 Accepting new patients
Central Ohio Urology Group, LLC CurrentSince Jul 3, 2023 Accepting new patients

Locations

8200 Hazelton Etna Rd SW
Etna, OH 43062
Phone (614) 221-5189

701 Tech Center Dr
Ste 250
Gahanna, OH 43230

701 Tech Center Dr
Gahanna, OH 43230
Phone (614) 944-4806

701 Tech Center Dr
Ste 100
Gahanna, OH 43230
Phone (440) 724-4498

601 State Route 664 N
Logan, OH 43138
Phone (740) 380-8000

819 State Route 664 N
Logan, OH 43138
Phone (740) 380-8140

350 W Wilson Bridge Rd
Ste 100
Worthington, OH 43085
Phone (614) 268-2323

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: rguest647749@direct.osumc.edu

Organizations & group practices 4

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 5

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": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1033885256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 DIXON CAVETT RD",
            "city": "CONVOY",
            "state": "OH",
            "postal_code": "458329501",
            "telephone_number": "419-513-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 E OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343241",
            "telephone_number": "313-369-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEST",
        "first_name": "RILEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.