Individual provider Active NPI

Ryan Rommel Soriano Guanzon, MD

  • Internal Medicine Physician
  • Mount Vernon, WA
National Provider Identifier
1417048893
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60091837 Issued in WA
Practice address
110 N Laventure Rd Ste C
Mount Vernon, WA 98273-3901
Phone
(360) 814-8240
Fax
(360) 848-4502
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 MD60091837 WA Primary
Internal Medicine Physician 207R00000X 41518 TN

Addresses

Primary practice location

110 N Laventure Rd Ste C
Mount Vernon, WA 98273-3901

Mailing address

1400 E. Kincaid Street
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

Other practice location 1

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 428-2592

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rguanzon15695@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20100119000162 WA Practitioner - Internal Medicine 7012011299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

Hospital & facility affiliations

  • Alpha Home Health Home health agency, Everett, WA, CCN 507107
  • Signature Healthcare at Home Home health agency, Burlington, WA, CCN 507100
  • Hospice of the Northwest Hospice, Mount Vernon, WA, CCN 501505
  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
  • Cascade Valley Hospital Hospital, Arlington, WA, CCN 500060

Merit-based Incentive Payment System (MIPS)

Final score
87.16 of 100Reported as apm
Quality
82.11
Promoting interoperability
87
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

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
Public Hospital Dist No 1 Skagit Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Jul 1, 2010 Accepting new patients
Public Hospital Dist No 1 Skagit Internal Medicine CurrentSince Jul 1, 2010 Accepting new patients
Multispecialty Medical P.C. Internal Medicine Past Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

1415 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 416-5750

110 N Laventure Rd
Ste C
Mount Vernon, WA 98273
Phone (360) 399-7700

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

110 N Laventure Rd
Mount Vernon, WA 98273
Phone (360) 424-5344

9631 269th St NW
Stanwood, WA 98292
Phone (360) 629-1600

Interoperability endpoints

  • Direct secure messaging: rguanzon15695@skagit.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1417048893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E. KINCAID STREET",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2500",
            "fax_number": "360-428-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N LAVENTURE RD STE C",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982733901",
            "telephone_number": "360-814-8240",
            "fax_number": "360-848-4502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744126",
            "country_code": "US",
            "telephone_number": "360-428-2592",
            "fax_number": "360-428-2560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUANZON",
        "first_name": "RYAN ROMMEL",
        "middle_name": "SORIANO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60091837",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "41518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rguanzon15695@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1415 E Kincaid St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.