NPIMap

Organization Active NPI

Guam Healthcare Development Incorporated

Doing business as Guam Regional Medical City

  • General Acute Care Hospital
  • Dededo, GU
National Provider Identifier
1194159525
Registry record updated Oct 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
GUAM HEALTHCARE DEVELOPMENT INCORPORATED
Doing business as
Guam Regional Medical City
Practice address
133 Route 3
Dededo, GU 96929-6911
Phone
(671) 645-5500
Fax
(671) 645-5549
NPI assigned
Aug 21, 2013
Last updated
Oct 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2024

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

Authorized official

Name
Alexander D. Wielaard, MDNPI 1144438995
Title
Chief Executive Officer
Phone
(706) 306-4668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

133 Route 3
Dededo, GU 96929-6911

Mailing address

133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500

Other names 1

  • Guam Regional Medical City Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141117001359 HI Part A Provider - Hospital 9234351776 Practice locations: Dededo, GU

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194159525. Details of each certification follow.

Hospital certification: CCN 650003

Legal name
GUAM HEALTHCARE DEVELOPMENT INCORPORATED
Doing business as
GUAM REGIONAL MEDICAL CITY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 8, 2016
Last certification
Oct 10, 2025
Beds
154 (130 certified)
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Incorporated
Aug 20, 2009 in GU
Enrollment address
133 Route 3
Dededo, GU 96929-6911
Other Hospital Practice Location
Hospital subgroups
General

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Guam Regional Medical CityCCN 650003 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas Johnston Smith Individual Corporate DirectorChairman/Director Nov 19, 2018
Alexander Duncan Wielaard Individual Corporate OfficerPresident & Ceo Aug 5, 2023
Corporate DirectorDirector Dec 1, 2021
Operational/Managerial Control Aug 5, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

Affiliated clinicians 199

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 199

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729987200000",
    "number": "1194159525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 ROUTE 3",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969296911",
            "telephone_number": "671-645-5500",
            "fax_number": "671-645-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ROUTE 3",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969296911",
            "telephone_number": "671-645-5500",
            "fax_number": "671-645-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUAM HEALTHCARE DEVELOPMENT INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A",
        "authorized_official_last_name": "WIELAARD",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "706-306-4668",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guam Regional Medical City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Guam Regional Medical City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dededo, GU

Sources for this page

Verify at the official NPI Registry.