Individual provider Active NPI

Emmanuel Diaz Guerrero, M.D.

  • Pediatrics Physician
  • Bronx, NY
National Provider Identifier
1275938482
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
281405 Issued in NY
Practice address
705 E 180TH St
Bronx, NY 10457-3601
Phone
(718) 220-0507
Fax
(718) 220-8419
NPI assigned
Oct 30, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 281405 NY Primary
Children's Hospital 282NC2000X

Addresses

Primary practice location

705 E 180TH St
Bronx, NY 10457-3601

Mailing address

705 E 180TH St
Bronx, NY 10457-3601
Phone (718) 220-0507

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171211000473 NY Practitioner - Pediatric Medicine 6800154311 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
281405NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
181St Street Medical P.C. Pediatrics CurrentSince Nov 1, 2020 Accepting new patients
Audubon Primary Care Medicine PLLC CurrentSince Nov 1, 2020 Accepting new patients
Pediatrics & OB/GYN of Ny PC Pediatrics Current Accepting new patients
Sun River Health Inc Current Accepting new patients
First Step Pediatrics, P. C. Past Accepting new patients
First Step Medical, P C Pediatrics Past Accepting new patients
St. John'S Riverside Hospital Past Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

1148 E Tremont Ave
Bronx, NY 10460
Phone 7183783438 ext. 7718

325 Audubon Ave
New York, NY 10033
Phone (718) 664-7679

521 W 181st St
New York, NY 10033
Phone (347) 756-6000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HJFDCD

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1275938482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E 180TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573601",
            "telephone_number": "718-220-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E 180TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104573601",
            "telephone_number": "718-220-0507",
            "fax_number": "718-220-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ GUERRERO",
        "first_name": "EMMANUEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-30",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "281405",
            "primary": true
        },
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.