Mateo Guardiola, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

S8562 Issued in TX

Practice address

611 N Frankford Ave
Lubbock, TX 79416-1545

Phone

(806) 725-5480

NPI assigned

Mar 28, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family Practice

Education

San Juan Bautista School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Covenant Medical Center Hospital, Lubbock, TX, CCN 450040
• Covenant Childrens Hospital Hospital, Lubbock, TX, CCN 453306
• Grace Surgical Hospital Hospital, Lubbock, TX, CCN 450162

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mguardiola1929251@oc.providencedirect.org

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.

• Covenant Medical Group

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1376598904
  Medicare reassignment Care Compare group NPD
• Covenant Medical Group

  • Rural Health Clinic/Center
  • Abernathy, TX
  • NPI 1538412895

  Family Medicine

  NPD

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

• Covenant Medical Center

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1972517365
  Care Compare affiliation
• Lubbock Heritage Hospital, LLC.

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1225289499
  Care Compare affiliation
• Methodist Children'S Hospital

  • Children's Hospital
  • Lubbock, TX
  • NPI 1437171568
  Care Compare affiliation

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1417452640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797634206",
            "telephone_number": "432-703-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N FRANKFORD AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794161545",
            "telephone_number": "806-725-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUARDIOLA",
        "first_name": "MATEO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S8562",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sergei A Gromov, MD PHD
• Michael Nicholas Gross, DC
• Dallin Thayne Grover, DPT
• Stephen Luke Grupke, MD, MS
• Jingjing Guan
• Cynthia Michelle Guerin, MD
• Edwin Orlando Guerra, PA-C
• Julius Gregory Guerra, MSN, APRN, ACNPC-AG
• Natalie Guerra
• Andrea Guerrero

• Family Medicine Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.