Individual provider Active NPI

Rafael Raymund Cuesta Guerrero

  • Nurse Practitioner
  • Bayville, NJ
National Provider Identifier
1205525045
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01478900 Issued in NJ
Practice address
53 Pelican Drive
Bayville, NJ 08721
Phone
(732) 930-4221
NPI assigned
May 8, 2023
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ01478900 NJ Primary

Addresses

Primary practice location

53 Pelican Drive
Bayville, NJ 08721

Mailing address

53 Pelican Drive
Bayville, NJ 08721
Phone (732) 930-4221

Other practice location 1

137 High St Fl 2A
Mount Holly, NJ 08060-1476
Phone (609) 474-0120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20230828003264 NJ Practitioner - Nurse Practitioner 3274996921 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Botox and Family Associates LLCGroup PAC ID 0840535993, 5 clinicians
Ocean Family and Geriatric Associates LLCGroup PAC ID 2567729171, 10 clinicians

Practice addresses (Care Compare)

20 Hospital Dr
Toms River, NJ 08755-6434
Phone (732) 341-9900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01478900NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of New Jersey, LLC Nurse Practitioner CurrentSince Feb 26, 2024 Accepting new patients
Botox and Family Associates LLC CurrentSince Aug 13, 2024 Accepting new patients
Clare Medical of New Jersey LLC Nurse Practitioner CurrentSince Nov 9, 2023 Accepting new patients
Ocean Family & Geriatric Associates LLC CurrentSince Mar 27, 2024 Accepting new patients
Vinod Sancheti Mdpa CurrentSince Jul 1, 2023 Accepting new patients

Locations

137 High St
Fl 2A
Mount Holly, NJ 08060
Phone (609) 474-0120

137 High St
Ste 2A
Mount Holly, NJ 08060
Phone (609) 447-3442

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 650-7800

20 Hospital Dr
Ste 3
Toms River, NJ 08755
Phone (732) 341-9900

25 Mule Rd
Ste 8
Toms River, NJ 08755
Phone (732) 240-4000

25 Mule Rd
Unit B8
Toms River, NJ 08755
Phone (732) 240-4000

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11700/brand/1/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1205525045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 PELICAN DRIVE",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "08721",
            "telephone_number": "732-930-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 PELICAN DRIVE",
            "city": "BAYVILLE",
            "state": "NJ",
            "postal_code": "08721",
            "telephone_number": "732-930-4221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 High St Fl 2A",
            "address_purpose": "LOCATION",
            "city": "Mount Holly",
            "state": "NJ",
            "postal_code": "080601476",
            "country_code": "US",
            "telephone_number": "609-474-0120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "RAFAEL RAYMUND",
        "middle_name": "CUESTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01478900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayville, NJ

Sources for this page

Verify at the official NPI Registry.