Individual provider Active NPI

Maria Sarah N. Guevarra, M.D.

  • Pediatric Endocrinology Physician
  • Nesconset, NY
National Provider Identifier
1174767529
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
242923 Issued in NY
Practice address
59A Nichols Rd
Nesconset, NY 11767-2093
Phone
(631) 656-6940
Fax
(631) 656-6940
NPI assigned
Apr 29, 2009
Last updated
Apr 29, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 242923 NY Primary

Addresses

Primary practice location

59A Nichols Rd
Nesconset, NY 11767-2093

Mailing address

59 A Nichols Road
Nesconset, NY 11767-2093
Phone (631) 656-6940

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180420000758 NY Practitioner - Pediatric MedicinePractitioner - Other (Physician) 7719240936 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
242923NYMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Pediatric Services, P.C. CurrentSince Mar 3, 2018 Accepting new patients

Locations

655 Deer Park Ave
Babylon, NY 11702
Phone (631) 321-2100

245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mguevarra39512@direct-chsli.net

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, 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": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1174767529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 A NICHOLS ROAD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672093",
            "telephone_number": "631-656-6940",
            "fax_number": "631-656-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59A NICHOLS RD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672093",
            "telephone_number": "631-656-6940",
            "fax_number": "631-656-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARRA",
        "first_name": "MARIA SARAH",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "242923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nesconset, NY

Sources for this page

Verify at the official NPI Registry.