Individual provider Active NPI

Mary C Deguardi, MD

  • Pediatrics Physician
  • Binghamton, NY
National Provider Identifier
1538111554
Registry record updated Feb 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
188996 Issued in NY
Practice address
10 - 42 Mitchell Ave
Binghamton Pediatrics
Binghamton, NY 13903
Phone
(607) 762-2468
NPI assigned
May 17, 2006
Last updated
Feb 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 188996 NY Primary

Addresses

Primary practice location

10 - 42 Mitchell Ave
Binghamton Pediatrics
Binghamton, NY 13903

Mailing address

58 Lusk St
Johnson City, NY 13790-2541
Phone (607) 763-6293

Other identifiers 1

IdentifierTypeStateIssuer
02045783MedicaidNY

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
I20050801000014 NY Practitioner - Pediatric Medicine 7012945157 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates PC CurrentSince Jun 1, 2019 Accepting new patients
United Medical Associates, P.C. CurrentSince Jun 1, 2019 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Jun 1, 2019 Accepting new patients

Locations

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

33 Lewis Rd
Ste 2
Binghamton, NY 13905

33 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2340

91 Chenango Bridge Rd
Binghamton, NY 13901
Phone (607) 648-4151

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

4433 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 762-2176

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1538111554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 LUSK ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902541",
            "telephone_number": "607-763-6293",
            "fax_number": "607-763-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 - 42 MITCHELL AVE",
            "address_2": "BINGHAMTON PEDIATRICS",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13903",
            "telephone_number": "607-762-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGUARDI",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "188996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02045783",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.