Individual provider Active NPI

Yazmin Johanna Soto Guerrero, M.D.

  • Internal Medicine Physician
  • Newport News, VA
National Provider Identifier
1104866482
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101260290 Issued in VA
Practice address
710 Denbigh Blvd
Newport News, VA 23608-4427
Phone
(787) 340-8175
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 201502105 NC
Hospitalist Physician 208M00000X 0101260290 VA
Internal Medicine Physician 207R00000X 0101260290 VA Primary
Single Specialty Group 193400000X 0101260290 VA

Addresses

Primary practice location

710 Denbigh Blvd
Newport News, VA 23608-4427

Mailing address

710 Denbigh Blvd
Newport News, VA 23608-4427
Phone (757) 897-2141

Other practice location 1

4000 Coliseum Dr Ste 445
Hampton, VA 23666-5981
Phone (757) 827-2127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20160808001082 VA Practitioner - Internal Medicine 3779580428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians

Practice addresses (Care Compare)

100 Sentara Cir
Suite 2C
Williamsburg, VA 23188-5713
Phone (757) 984-7217

Hospital & facility affiliations

  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201502105NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group Single Specialty CurrentSince Dec 12, 2016 Accepting new patients
Renova Internal Medicine Single Specialty PastSince Jul 1, 2016 Accepting new patients
Family Health Group S.S.C.S.P Single Specialty Past Accepting new patients

Locations

4000 Coliseum Dr
Ste 445
Hampton, VA 23666
Phone (757) 827-2127

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

100 Sentara Cir
Ste 2C
Williamsburg, VA 23188
Phone (757) 984-7217

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1104866482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 DENBIGH BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084427",
            "telephone_number": "757-897-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 DENBIGH BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084427",
            "telephone_number": "787-340-8175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Coliseum Dr Ste 445",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236665981",
            "country_code": "US",
            "telephone_number": "757-827-2127",
            "fax_number": "757-827-2255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOTO GUERRERO",
        "first_name": "YAZMIN",
        "middle_name": "JOHANNA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "201502105",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "VA",
            "license": "0101260290",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101260290",
            "primary": true
        },
        {
            "code": "193400000X",
            "taxonomy_group": "",
            "desc": "Single Specialty",
            "state": "VA",
            "license": "0101260290",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.