Individual provider Active NPI

Julio C Guerra, MD

  • Pediatrics Physician
  • Randolph, NJ
National Provider Identifier
1154432276
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA05950700 Issued in NJ
Practice address
765 RT 10 East Suite 203
College Plaza Pediatrics
Randolph, NJ 07869-1925
Phone
(973) 659-9991
Fax
(973) 659-9632
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MA057052 NJ
Pediatrics Physician 208000000X 25MA05950700 NJ Primary

Addresses

Primary practice location

765 RT 10 East Suite 203
College Plaza Pediatrics
Randolph, NJ 07869-1925

Mailing address

765 RT 10 East Suite 203
College Plaza Pediatrics
Randolph, NJ 07869-1925
Phone (973) 659-9991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05950700NJMDPediatrics Physician
MA057052NJMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
College Plaza Pediatrics Pediatrics 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337644800000",
    "number": "1154432276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 RT 10 EAST SUITE 203",
            "address_2": "COLLEGE PLAZA PEDIATRICS",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691925",
            "telephone_number": "973-659-9991",
            "fax_number": "973-659-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 RT 10 EAST SUITE 203",
            "address_2": "COLLEGE PLAZA PEDIATRICS",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691925",
            "telephone_number": "973-659-9991",
            "fax_number": "973-659-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "JULIO",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "MA057052",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05950700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.