Active NPI
Benjamin Guzman, OTR/L
- Occupational Therapist
- Mesa, AZ
National Provider Identifier
1215618756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 009242
- Practice address
- 63 E Main St
Mesa, AZ 85201-7417 - Phone
- (480) 472-0115
- NPI assigned
- Jul 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 009242 | AZ | Primary |
Addresses
Primary practice location
63 E Main St
Mesa, AZ 85201-7417
Mailing address
1321 W Irisado Cir
Mesa, AZ 85202-5814
Phone (760) 927-0739
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009242 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690416000000",
"number": "1215618756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 W IRISADO CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852025814",
"telephone_number": "760-927-0739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 E MAIN ST",
"city": "MESA",
"state": "AZ",
"postal_code": "852017417",
"telephone_number": "480-472-0115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUZMAN",
"first_name": "BENJAMIN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-27",
"last_updated": "2023-07-27",
"certification_date": "2023-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "009242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.