Gabriel Guerrero, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

O-1094 Issued in ID

Practice address

74 N Fisher Park Way
Eagle, ID 83616-4704

Phone

(208) 391-7210

Fax

(208) 391-2130

NPI assigned

Jan 5, 2016

Last updated

Oct 31, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

DermatologyAlso: Micrographic Dermatologic Surgery (MDS)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eagle Dermatology PLLCGroup PAC ID 1658636048, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.37 of 100Reported as individual

Quality

80.5

Promoting interoperability

97

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00113

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.

• Eagle Dermatology, PLLC

  • Dermatology Physician
  • Eagle, ID
  • NPI 1417456385
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1184080210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "372 S EAGLE RD # 126",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165908",
            "telephone_number": "208-391-7210",
            "fax_number": "208-391-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 N FISHER PARK WAY",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164704",
            "telephone_number": "208-391-7210",
            "fax_number": "208-391-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-05",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "ID",
            "license": "O-1094",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "O-1094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniela Grigore, MD
• Grit Mobility Concepts, LLC
• Janet Lee Groeger, LMT
• Brian Grogan, MD
• Felicia Groves
• Tawnya Marie Hughes Guimond, LM, CPM
• Joshua Guinter, DPT
• Leslie Gwen Gunnerson, R.N., I.B.C.L.C.
• H&LL LLC (EverydayEar)
• Robert John Haake, D.O.

• Dermatology Physician in Eagle, ID
• Providers in Eagle, ID by specialty
• Dermatology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.