NPIMap

Individual provider Active NPI

Edson De Guzman, MD

  • Cardiovascular Disease Physician
  • Midlothian, VA
National Provider Identifier
1174512198
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
0101057505 Issued in VA
Practice address
13572 Waterford PL
Midlothian, VA 23112-3928
Phone
(804) 560-8782
Fax
(804) 525-2525
NPI assigned
Oct 21, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 0101057505 VA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 0101057505 VA

Addresses

Primary practice location

13572 Waterford PL
Midlothian, VA 23112-3928

Mailing address

13572 Waterford PL
Midlothian, VA 23112-3928
Phone (804) 560-8828

Other identifiers 1

IdentifierTypeStateIssuer
005862833MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040831000584 VA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7618942939 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiology of Virginia IncGroup PAC ID 4385601376, 4 clinicians

Practice addresses (Care Compare)

13572 Waterford PL
Midlothian, VA 23112-3928
Phone (804) 560-8782

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.7 of 100Reported as group
Quality
66.36
Improvement activities
40
Cost
63.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101057505VAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chippenham & Johnston-Willis Hospitals, Inc. CurrentSince Jun 20, 2015 Accepting new patients
Cardiology of Virginia, Inc. Cardiovascular Disease CurrentSince Jul 1, 2001 Accepting new patients
Chippenham & Johnston-Willis Hospitals, Inc. Current Accepting new patients
Cardiology Clinic of Muskogee, Inc. Cardiovascular Disease Past Accepting new patients

Locations

13572 Waterford Pl
Midlothian, VA 23112
Phone (804) 560-8782

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3442/brand/1/csg/61/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174512198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13572 WATERFORD PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231123928",
            "telephone_number": "804-560-8828",
            "fax_number": "804-525-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13572 WATERFORD PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231123928",
            "telephone_number": "804-560-8782",
            "fax_number": "804-525-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GUZMAN",
        "first_name": "EDSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0101057505",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101057505",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005862833",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.