Active NPI
Eric Enrico Guardino, M.D.
- Internal Medicine Physician
- Lexington, MA
National Provider Identifier
1497880207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 57734
- Practice address
- 16 Clarke St
Unit B4
Lexington, MA 02421-4988 - Phone
- (781) 863-6053
- Fax
- (781) 862-7565
- NPI assigned
- Feb 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 57734 | MA | Primary |
Addresses
Primary practice location
16 Clarke St
Unit B4
Lexington, MA 02421-4988
Mailing address
16 Clarke St
Unit B4
Lexington, MA 02421-4988
Phone (781) 863-6053
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3034895 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57734 | MA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209945600000",
"number": "1497880207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 CLARKE ST",
"address_2": "UNIT B4",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024214988",
"telephone_number": "781-863-6053",
"fax_number": "781-862-7565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 CLARKE ST",
"address_2": "UNIT B4",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024214988",
"telephone_number": "781-863-6053",
"fax_number": "781-862-7565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUARDINO",
"first_name": "ERIC",
"middle_name": "ENRICO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2008-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "57734",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3034895",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.