Individual provider Active NPI

Michelle Hernandez Guzman

  • Internal Medicine Physician
  • Roslyn Heights, NY
National Provider Identifier
1386179521
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
303136 Issued in NY
Practice address
70 Glen Cove Rd Ste 306
Roslyn Heights, NY 11577-1731
Phone
(516) 621-7720
Fax
(166) 254-5215
NPI assigned
Apr 25, 2017
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 303136 NY Primary

Addresses

Primary practice location

70 Glen Cove Rd Ste 306
Roslyn Heights, NY 11577-1731

Mailing address

70 Glen Cove Rd Ste 306
Roslyn Heights, NY 11577-1731
Phone (516) 621-7720

Other names 1

  • Michelle Hernandez Other name

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
I20201217000204 NY Practitioner - Internal Medicine 5193060283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Toledo Medical College, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.13 of 100Reported as group
Quality
72.13
Promoting interoperability
91
Improvement activities
40
Cost
75.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
303136NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Dynamic Physical Therapy & Rehab Services P.C CurrentSince Oct 1, 2023 Accepting new patients
M J Meltzer & D G Kassan MD LLP Internal Medicine CurrentSince Oct 1, 2023 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

70 Glen Cove Rd
Ste 306
Roslyn Heights, NY 11577
Phone (516) 567-6312

Philadelphia, PA 19195

Interoperability endpoints

  • Direct secure messaging: mhernandezguzman18541@direct.optum.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1386179521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GLEN COVE RD STE 306",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771731",
            "telephone_number": "516-621-7720",
            "fax_number": "516-625-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN COVE RD STE 306",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115771731",
            "telephone_number": "516-621-7720",
            "fax_number": "166-254-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ GUZMAN",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "303136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "HERNANDEZ",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roslyn Heights, NY

Sources for this page

Verify at the official NPI Registry.