Individual provider Active NPI

Kirstin Maree Anderson Raguindin, DO

  • Family Medicine Physician
  • Tamuning, GU
National Provider Identifier
1164044285
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-0126 Issued in GU
Practice address
1244 N Marine Corps Dr
Tamuning, GU 96913-4308
Phone
(671) 647-8262
NPI assigned
May 12, 2020
Last updated
May 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO-0126 GU Primary
Student in an Organized Health Care Education/Training Program 390200000X TL000 CO

Addresses

Primary practice location

1244 N Marine Corps Dr
Tamuning, GU 96913-4308

Mailing address

1244 Marine Corps Dr
Upper Tumon, GU 96913
UM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20231019002754 GU Practitioner - Family Practice 6406272368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rocky Vista University College of Osteopathic Med, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Medical Center, LLCGroup PAC ID 1759311699, 17 clinicians

Practice addresses (Care Compare)

1244 N Marine Corps Dr
Tamuning, GU 96913
Phone (671) 647-8262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-0126GUMDFamily Medicine Physician
TL000COMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
American Medical Center, LLC CurrentSince Sep 25, 2023 Accepting new patients
St Mary's Hospital and Medical Center, Inc Family Medicine PastSince May 1, 2020 Accepting new patients
AMC Mental Health, LLC PastSince Jun 2, 2024 Accepting new patients

Locations

1244 N Marine Corps Dr
Tamuning, GU 96913
Phone (671) 647-8262

1244 N Marine Corps Dr
Uppr
Tamuning, GU 96913
Phone (671) 647-8262

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1164044285",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "1244 MARINE CORPS DR",
            "city": "UPPER TUMON",
            "state": "GU",
            "postal_code": "96913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 N MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134308",
            "telephone_number": "671-647-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGUINDIN",
        "first_name": "KIRSTIN MAREE",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-12",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GU",
            "license": "DO-0126",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.