Individual provider Active NPI

Guillermo F Campos, MD

  • Emergency Medicine Physician
  • Humaco, PR
National Provider Identifier
1104893460
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
12308 Issued in PR
Practice address
Ryder Memorial Hospital
355 Ave Font Martelo
Humaco, PR 00791
Phone
(787) 852-0768
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 12308 PR Primary

Addresses

Primary practice location

Ryder Memorial Hospital
355 Ave Font Martelo
Humaco, PR 00791

Mailing address

PMB 171 Box 4956
Caguas, PR 00726-4956
Phone (787) 469-0572

Other identifiers 1

IdentifierTypeStateIssuer
037940900MedicaidPR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20040505000261 PR Practitioner - Emergency Medicine 4688662984 Practice locations: Caguas, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millenium Medical Emergency Group Past Accepting new patients

Organizations & group practices 1

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1104893460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 171 BOX 4956",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007264956",
            "telephone_number": "787-469-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RYDER MEMORIAL HOSPITAL",
            "address_2": "355 AVE FONT MARTELO",
            "city": "HUMACO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-852-0768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "GUILLERMO",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PR",
            "license": "12308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037940900",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.