Individual provider Active NPI

Andre D. Guillet, D.P.M.

  • Podiatrist
  • Brooklyn, NY
National Provider Identifier
1205964962
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
005911 Issued in NY
Practice address
148 Wilson Avenue
Comprehensive Health Care & Rehabilation Services, LLC
Brooklyn, NY 11237-3149
Phone
(718) 455-5500
Fax
(718) 455-8700
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 005911 NY Primary

Addresses

Primary practice location

148 Wilson Avenue
Comprehensive Health Care & Rehabilation Services, LLC
Brooklyn, NY 11237-3149

Mailing address

166 Miriam Pkwy
Elmont, NY 11003-4429
Phone (516) 770-9763

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040409000311 NY Practitioner - Podiatry 4486648839 Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005911NYMDAcupuncturist

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205964962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 MIRIAM PKWY",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110034429",
            "telephone_number": "516-770-9763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 WILSON AVENUE",
            "address_2": "COMPREHENSIVE HEALTH CARE & REHABILATION SERVICES, LLC",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112373149",
            "telephone_number": "718-455-5500",
            "fax_number": "718-455-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLET",
        "first_name": "ANDRE",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "005911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.