Individual provider Active NPI

Natasha Julymarie Carrasquillo Guadalupe, MD

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1417698465
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
338777 Issued in NY
Practice address
9701 Northern Blvd
Flushing, NY 11368-1043
Phone
(718) 765-6053
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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 338777 NY Primary

Addresses

Primary practice location

9701 Northern Blvd
Flushing, NY 11368-1043

Mailing address

PO Box 740015
Atlanta, GA 30374-0015
Phone (312) 733-9730

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
I20251119002952 NY Practitioner - Internal Medicine 1153812946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Griffin Myers Medical PCGroup PAC ID 5294145017, 78 clinicians

Practice addresses (Care Compare)

9701 Northern Blvd
Flushing, NY 11368-1043
Phone (718) 765-6053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
338777NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health of Georgia PC Internal Medicine CurrentSince Nov 18, 2025 Accepting new patients
Griffin Myers Medical, P.C. Internal Medicine CurrentSince Jan 5, 2026 Accepting new patients

Locations

455 Sutter Ave
Brooklyn, NY 11212
Phone (718) 765-6550

9701 Northern Blvd
Flushing, NY 11368
Phone (718) 765-6053

11515 Sutphin Blvd
Jamaica, NY 11434
Phone (718) 659-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1417698465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740015",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740015",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 NORTHERN BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113681043",
            "telephone_number": "718-765-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASQUILLO GUADALUPE",
        "first_name": "NATASHA",
        "middle_name": "JULYMARIE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "338777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.