Charise Yvonne Guadarrama, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

011162 Issued in NY

Practice address

93-19 Roosevelt Avenue
Jackson Heights, NY 11372

Phone

(718) 803-8463

Fax

(718) 803-8465

NPI assigned

Jul 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Lij Urgent Care PCGroup PAC ID 6002131778, 389 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: charise.guadarrama@ghuc.eclinicaldirectplus.com

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.

• North Shore Lij, Urgent Care, P.C.

  • Urgent Care Clinic/Center
  • Rockville Centre, NY
  • NPI 1679970891
  Medicare reassignment Care Compare group
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212537600000",
    "number": "1124046305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 MALTS AVE",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952509",
            "telephone_number": "631-888-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93-19 ROOSEVELT AVENUE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372",
            "telephone_number": "718-803-8463",
            "fax_number": "718-803-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADARRAMA",
        "first_name": "CHARISE",
        "middle_name": "YVONNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02850219",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanasha Green
• Jacob Greenfeld, PHARM. D.
• Abigail L Gresla, LMSW
• Michael Grinman, PHARMD
• Caroline Ray Growney
• Guardiola Pharmacy Inc
• Carlos E Guerra
• Paola Cristina Guevara, RN
• Gulistan Pharmacy Inc
• Cecilia Kilayko Gullas, R.N.

• Physician Assistant in Jackson Heights, NY
• Providers in Jackson Heights, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.