Individual provider Active NPI

Vilben Michael Merza De Guzman, NP

  • Gerontology Nurse Practitioner
  • San Clemente, CA
National Provider Identifier
1205228947
Registry record updated Mar 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
95002149 Issued in CA
Practice address
1001 Avenida Pico
C517
San Clemente, CA 92673-6957
Phone
(949) 226-8416
NPI assigned
Mar 3, 2015
Last updated
Mar 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 95002149 CA Primary

Addresses

Primary practice location

1001 Avenida Pico
C517
San Clemente, CA 92673-6957

Mailing address

1001 Avenida Pico
C517
San Clemente, CA 92673-6957
Phone (949) 226-8416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150429000224 CA Practitioner - Nurse Practitioner 7416276209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Regents of the University of California-IrvineGroup PAC ID 3971609611, 116 clinicians

Practice addresses (Care Compare)

101 The City Dr S
Orange, CA 92868-3201
Phone (714) 456-7890

101 The City S Dr
Suite 58
Orange, CA 92868-3201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
83.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95002149CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California-Irvine CurrentSince May 12, 2017 Accepting new patients
UC Regents CurrentSince Aug 30, 2017 Accepting new patients
UC Regents CurrentSince Aug 30, 2017 Accepting new patients
UC Regents Current Accepting new patients
Joomo Yang, MD., Inc. Past Accepting new patients

Locations

101 The City Dr S
Orange, CA 92868
Phone (714) 456-6054

Interoperability endpoints

  • Direct secure messaging: vmichaeldeguzman876515@direct.memorialcare.org

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 2

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": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1205228947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 AVENIDA PICO",
            "address_2": "C517",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736957",
            "telephone_number": "949-226-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 AVENIDA PICO",
            "address_2": "C517",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736957",
            "telephone_number": "949-226-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GUZMAN",
        "first_name": "VILBEN MICHAEL",
        "middle_name": "MERZA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-03",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "95002149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.