Individual provider Active NPI

Raquel P Deguzman, MD

  • Internal Medicine Physician
  • Macon, GA
National Provider Identifier
1174785216
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
066021 Issued in GA
Practice address
777 Hemlock St
Macon, GA 31201-2102
Phone
(478) 741-7241
Fax
(478) 745-8932
NPI assigned
Jun 30, 2008
Last updated
May 17, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 066021 GA Primary
Hospitalist Physician 208M00000X 066021 GA

Addresses

Primary practice location

777 Hemlock St
Macon, GA 31201-2102

Mailing address

657 Hemlock St
Suite 220
Macon, GA 31201-8329
Phone (478) 741-7241

Other identifiers 1

IdentifierTypeStateIssuer
0003112187MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20110909002547 GA Practitioner - Internal Medicine 5294905865 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Georgia PCGroup PAC ID 2961483607, 252 clinicians
Cogent Healthcare of Macon, LLCGroup PAC ID 9234104019, 73 clinicians

Practice addresses (Care Compare)

1170 Cleveland Ave
East Point, GA 30344-3615
Phone (404) 466-1170

400 Charter Blvd
Macon, GA 31210-4831
Phone (478) 757-8200

777 Hemlock St
Macon, GA 31201-2102
Phone (478) 633-7444

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
066021GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Dorminy Surgical Associates CurrentSince May 1, 2016 Accepting new patients
Phoebe Physician Group, Inc CurrentSince May 1, 2016 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Macon Northside Hospital, LLC Past Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

350 Hospital Dr
Macon, GA 31217
Phone (478) 751-0367

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

Organizations & group practices 5

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1174785216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 HEMLOCK ST",
            "address_2": "SUITE 220",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018329",
            "telephone_number": "478-741-7241",
            "fax_number": "478-745-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-741-7241",
            "fax_number": "478-745-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGUZMAN",
        "first_name": "RAQUEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "066021",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "066021",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003112187",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.