Individual provider Active NPI

Yesenia Guzman

  • Physician Assistant
  • Buffalo Grove, IL
National Provider Identifier
1043955818
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085009171 Issued in IL
Practice address
600 W Lake Cook Rd Ste 120
Buffalo Grove, IL 60089-2085
Phone
(847) 808-8884
Fax
(847) 808-8890
NPI assigned
May 4, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2024

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 085009171 IL Primary

Addresses

Primary practice location

600 W Lake Cook Rd Ste 120
Buffalo Grove, IL 60089-2085

Mailing address

600 W Lake Cook Rd Ste 120
Buffalo Grove, IL 60089-2085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20221019000319 IL Practitioner - Physician Assistant 0547636383 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085009171ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Healthfirst L.L.C Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: yesenia.guzman.p1@direct.gefcc.nextgenshare.com
  • Direct secure messaging: yesenia.guzman.1@380.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1043955818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W LAKE COOK RD STE 120",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W LAKE COOK RD STE 120",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600892085",
            "telephone_number": "847-808-8884",
            "fax_number": "847-808-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "YESENIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-04",
        "last_updated": "2024-05-23",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo Grove, IL

Sources for this page

Verify at the official NPI Registry.