Eric Tabamo Guzman, MS, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

974-124 Issued in WI

Practice address

2009 5TH St
Monroe, WI 53566-1546

Phone

(608) 324-2000

NPI assigned

Sep 14, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Eric Tabamo Guzman Professional name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Monroe Clinic, Inc.Group PAC ID 3072425495, 199 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Monroe Clinic Hospital, Monroe, WI, CCN 520028

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eguzman443026@direct-ehr-ssmhc.com

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.

• The Monroe Clinic, Inc.

  dba SSM Health Monroe Clinic Medical Group

  • Specialist
  • Monroe, WI
  • NPI 1386720548
  Medicare reassignment Care Compare group NPD
• The Monroe Clinic, Inc.

  dba SSM Health Monroe Hospital

  • General Acute Care Hospital
  • Monroe, WI
  • NPI 1740291491
  NPD
• Uplands Counseling Associates, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1770599078
  NPD

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

• The Monroe Clinic, Inc.

  dba SSM Health Monroe Hospital

  • General Acute Care Hospital
  • Monroe, WI
  • NPI 1740291491
  Care Compare affiliation

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1558694125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 RIVER ST",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539011946",
            "telephone_number": "608-617-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2009 5TH ST",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661546",
            "telephone_number": "608-324-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6602 Grand Teton Plz Ste 1",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537191091",
            "country_code": "US",
            "telephone_number": "608-828-3636",
            "fax_number": "608-828-3637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1118 Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Dodgeville",
            "state": "WI",
            "postal_code": "535331176",
            "country_code": "US",
            "telephone_number": "608-935-2838",
            "fax_number": "608-742-4087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUZMAN",
        "first_name": "ERIC",
        "middle_name": "TABAMO",
        "name_prefix": "Mr.",
        "credential": "MS, MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-14",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "974-124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558694125",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eguzman443026@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "eguzman443026@direct-ehr-ssmhc.com",
            "address_1": "2009 5th St",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2009 5th St",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ERIC",
            "last_name": "GUZMAN",
            "middle_name": "TABAMO",
            "prefix": "MR.",
            "credential": "MS, MFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Marriage & Family Therapist in Monroe, WI
• Providers in Monroe, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.