Active NPI
Mary Jean S. Deguzman, MD
- Dermatopathology (Pathology) Physician
- Pompano Beach, FL
National Provider Identifier
1275518201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatopathology (Pathology) Physician
- License
- ME70419
- Practice address
- 895 SW 30TH Ave
Suite 101
Pompano Beach, FL 33069-4887 - Phone
- (954) 633-3387
- Fax
- (954) 633-3217
- NPI assigned
- Dec 13, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology (Pathology) Physician | 207ZD0900X | ME70419 | FL | Primary |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | ME70419 | FL |
Addresses
Primary practice location
895 SW 30TH Ave
Suite 101
Pompano Beach, FL 33069-4887
Mailing address
12596 NW 67TH Dr
Parkland, FL 33076-1961
Phone (954) 340-7041
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 252471200 | Medicaid | FL | |
| 220019667 | Other | FL | RR MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME70419 | FL | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kilpatrick Pathology PA | Past | Accepting new patients | |
| Universal Physical Medicine Associates Inc | Past | Accepting new patients | |
| Universal Physical Medicine Associates Inc | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Organizations & group practices 3
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.
-
- Physical Medicine & Rehabilitation Physician
- Hollywood, FL
- NPI 1396997904
-
- Physical Medicine & Rehabilitation Physician
- North Miami Beach, FL
- NPI 1669730164
-
- Clinical Medical Laboratory
- King, NC
- NPI 1124035316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371427200000",
"number": "1275518201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12596 NW 67TH DR",
"city": "PARKLAND",
"state": "FL",
"postal_code": "330761961",
"telephone_number": "954-340-7041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "895 SW 30TH AVE",
"address_2": "SUITE 101",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330694887",
"telephone_number": "954-633-3387",
"fax_number": "954-633-3217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGUZMAN",
"first_name": "MARY JEAN",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-13",
"last_updated": "2013-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207ZD0900X",
"taxonomy_group": "",
"desc": "Pathology, Dermatopathology",
"state": "FL",
"license": "ME70419",
"primary": true
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "FL",
"license": "ME70419",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "252471200",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "220019667",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.