Individual provider Active NPI

Jesus David Guevara-Nieto, MD

  • Hospitalist Physician
  • Rome, GA
National Provider Identifier
1407966591
Registry record updated Jul 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
D68405 Issued in MD
Practice address
330 Turner McCall Blvd SW
Suite 201
Rome, GA 30165-5630
Phone
(706) 509-4340
Fax
(706) 291-2147
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 051942 GA
Hospitalist Physician 208M00000X D68405 MD Primary

Addresses

Primary practice location

330 Turner McCall Blvd SW
Suite 201
Rome, GA 30165-5630

Mailing address

330 Turner McCall Blvd SW
Suite 201
Rome, GA 30165-5630
Phone (706) 509-4340

Other identifiers 1

IdentifierTypeStateIssuer
636426670AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20100512000636 DC Practitioner - HospitalistPractitioner - Internal Medicine 8123088473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

14207 Park Ctr Dr
Suite 102
Laurel, MD 20707-5255
Phone (301) 604-5254

8600 Old Georgetown Rd
Bethesda, MD 20814-1422
Phone (301) 896-3100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
80.47
Promoting interoperability
100
Improvement activities
40
Cost
76.96

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Hospital, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jguevaranieto158726@direct.hopkinsmedicine.org

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500595200000",
    "number": "1407966591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 TURNER MCCALL BLVD SW",
            "address_2": "SUITE 201",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301655630",
            "telephone_number": "706-509-4340",
            "fax_number": "706-291-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 TURNER MCCALL BLVD SW",
            "address_2": "SUITE 201",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301655630",
            "telephone_number": "706-509-4340",
            "fax_number": "706-291-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA-NIETO",
        "first_name": "JESUS",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "051942",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MD",
            "license": "D68405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "636426670A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.