Individual provider Active NPI

Glendell Santiago De Guzman, M.D.

  • Obstetrics & Gynecology Physician
  • Las Vegas, NV
National Provider Identifier
1174819064
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
18236 Issued in NV
Practice address
6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone
(702) 255-3547
Fax
(702) 921-2419
NPI assigned
Jun 20, 2011
Last updated
Nov 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 263048 MA
Obstetrics & Gynecology Physician 207V00000X 18236 NV Primary

Addresses

Primary practice location

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133

Mailing address

6355 S Buffalo Dr FL 3
Las Vegas, NV 89113-2133
Phone (702) 216-3346

Other practice location 1

1611 Cambridge St
Cambridge, MA 02138-4302
Phone (617) 661-5585

Other practice location 2

2231 W Charleston Blvd Fl 2
Las Vegas, NV 89102
Phone (702) 780-2312

Other practice location 3

9260 W Sunset Rd Ste 200
Las Vegas, NV 89148-4903
Phone (702) 216-3346

Other names 1

  • Dr. Glendell De Guzman Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20181218001478 NV Practitioner - Obstetrics/Gynecology 4486803343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Pennsylvania State University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unlv MedicineGroup PAC ID 4183991458, 177 clinicians

Practice addresses (Care Compare)

1707 W Charleston Blvd
Las Vegas, NV 89102-2352

1707 W Charleston Blvd
Las Vegas, NV 89102-2353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
263048MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Unlv Medicine CurrentSince Dec 1, 2018 Accepting new patients
Intermountain Medical Holdings Nevada Inc Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Unlv Medicine Current Accepting new patients
Healthcare Partners Medical Group Coats LTD Family Medicine Current Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Unlv Medicine CurrentSince Dec 1, 2018 Accepting new patients
University Medical Center of Southern Nevada Past Accepting new patients
Sunrise Hospital and Medical Center, LLC Past Accepting new patients

Locations

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

1707 W Charleston Blvd
Ste 100
Las Vegas, NV 89102
Phone (702) 676-3650

1707 W Charleston Blvd
Ste 110
Las Vegas, NV 89102
Phone (702) 671-2300

1707 W Charleston Blvd
Ste 220
Las Vegas, NV 89102
Phone (702) 671-5070

2231 W Charleston Blvd
Fl 2
Las Vegas, NV 89102
Phone (702) 944-2805

2410 Fire Mesa St
Ste 180
Las Vegas, NV 89128
Phone (702) 202-2700

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

3196 S Maryland Pkwy
Ste 303
Las Vegas, NV 89109
Phone (702) 383-2919

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

6355 S Buffalo Dr
Las Vegas, NV 89113
Phone (702) 952-9171

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

Organizations & group practices 8

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1174819064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-216-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 S BUFFALO DR FL 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891132133",
            "telephone_number": "702-255-3547",
            "fax_number": "702-921-2419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021384302",
            "country_code": "US",
            "telephone_number": "617-661-5585",
            "fax_number": "617-661-5107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2231 W Charleston Blvd Fl 2",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "89102",
            "country_code": "US",
            "telephone_number": "702-780-2312",
            "fax_number": "702-895-4014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9260 W Sunset Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891484903",
            "country_code": "US",
            "telephone_number": "702-216-3346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE GUZMAN",
        "first_name": "GLENDELL",
        "middle_name": "SANTIAGO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "263048",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "18236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDELL",
            "last_name": "DE GUZMAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.