NPIMap

Individual provider Active NPI

Lupe Guerra Jr.

  • Physician Assistant
  • Lutz, FL
National Provider Identifier
1205319019
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9110992 Issued in FL
Practice address
2971 Pearson James PL
Lutz, FL 33559-6996
Phone
(813) 388-2347
Fax
(813) 345-8999
NPI assigned
Sep 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9110992 FL Primary

Addresses

Primary practice location

2971 Pearson James PL
Lutz, FL 33559-6996

Mailing address

7765 Brian Loop
Lakeland, FL 33810-5137

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lupe.guerra@fcn.eclinicaldirectplus.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220609001525 FL Practitioner - Physician Assistant 4981082518 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

Hospital & facility affiliations

  • Angels Care Home Health Home health agency, Clermont, FL, CCN 108236
  • Orlando Health South Lake Hospital Hospital, Clermont, FL, CCN 100051
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007
  • Orlando Health-Health Central Hospital Hospital, Ocoee, FL, CCN 100030
  • Orlando Health Hospital, Orlando, FL, CCN 100006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony United Florida, LLC CurrentSince Aug 1, 2022 Accepting new patients
Tampa Neurology Associates PastSince Jul 21, 1996 Accepting new patients

Locations

2753 Citrus Tower Blvd
Clermont, FL 34711
Phone (352) 404-7570

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lupe.guerra@fcn.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1536451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1205319019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7765 BRIAN LOOP",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338105137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2971 PEARSON JAMES PL",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335596996",
            "telephone_number": "813-388-2347",
            "fax_number": "813-345-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "LUPE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-09",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9110992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lupe.guerra@fcn.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2971 Pearson James Pl",
            "city": "Lutz",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335596996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.