Michael Emile Guillette, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

889 Issued in CO

Practice address

2577 Main Ave
Durango, CO 81301-5919

Phone

(970) 247-8382

Fax

(970) 259-4403

NPI assigned

Oct 20, 2005

Last updated

Oct 18, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, NM2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Durango Urgent Care LLCGroup PAC ID 9335141266, 18 clinicians

Aztec Urgent Care, LLCGroup PAC ID 7810189016, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Regional Medical Center Hospital, Durango, CO, CCN 060013

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Durango Urgent Care LLC

  • Urgent Care Clinic/Center
  • Durango, CO
  • NPI 1154354512
  Medicare reassignment Care Compare group
• Aztec Urgent Care, LLC

  dba Four Corners Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Aztec, NM
  • NPI 1063741163
  Medicare reassignment Care Compare group
• Southwest Emergency Physicians, PC

  • Emergency Medicine Physician
  • Durango, CO
  • NPI 1568495653

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  dba Mercy Hospital

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1083611644
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  dba MMC DUC Diagnostic Imaging

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1588204010
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  dba Mercy Imaging Center

  • General Acute Care Hospital
  • Durango, CO
  • NPI 1679113104
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • Aztec, NM
  • NPI 1770123382
  Care Compare affiliation

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1174512115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2577 MAIN AVE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015919",
            "telephone_number": "970-247-8382",
            "fax_number": "970-259-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2577 MAIN AVE",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015919",
            "telephone_number": "970-247-8382",
            "fax_number": "970-259-4403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 S Rio Grande Ave",
            "address_purpose": "LOCATION",
            "city": "Aztec",
            "state": "NM",
            "postal_code": "874102260",
            "country_code": "US",
            "telephone_number": "505-334-2664",
            "fax_number": "505-334-7759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUILLETTE",
        "first_name": "MICHAEL",
        "middle_name": "EMILE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicklas L Groskopf, D.D.S.
• Richard Grossman, MD, MPH
• Groundswell Acupuncture LLC
• Sarah Louise Gueli, M.D.
• Elizabeth Guilfoyle, OTR/L
• Catherine Gustavson, RN
• Arlene Marie Gutierrez, CSFA
• Julia Gwyther, L.AC.
• Amy Hackmeier, LCSW
• Isaac Eli Hall, MD, MS

• Physician Assistant in Durango, CO
• Providers in Durango, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.