Nerissa S. Guballa, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

220632-1 Issued in NY

Practice address

408 E 76TH St
New York, NY 10021-3104

Phone

(212) 249-0900

NPI assigned

Nov 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2013 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: guballlanerissa.nerissaguballa@113550.advancedmd-direct.com
• Direct secure messaging: nsguball@direct.nyp.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nerissa Guballa MD PC

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1003984162
  NPD (past) Authorized official

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1194906529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E 76TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213104",
            "telephone_number": "212-249-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E 76TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100213104",
            "telephone_number": "212-249-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUBALLA",
        "first_name": "NERISSA",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "220632-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Guarnaccia, MD
• Sarah Christine Guarneri
• Giovanna Guarnieri, LMSW
• Franci Guastella, PHARM.D
• Laura Guastini, L.C.S.W.
• Kenneth Guber, MD
• Robert Douglas Guber
• Carmen Guberina, MD
• Alice Tanya Guberman
• Eugene Guberman, M.A.

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.