Individual provider Active NPI

Justin B Guerin, PA-C

  • Physician Assistant
  • Newark, DE
National Provider Identifier
1588830194
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0005942 Issued in DE
Practice address
4755 Ogletown Stanton Rd Ste 2670
Newark, DE 19718-2200
Phone
(302) 733-2438
NPI assigned
May 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA050950 PA
Physician Assistant 363A00000X C5-0005942 DE Primary

Addresses

Primary practice location

4755 Ogletown Stanton Rd Ste 2670
Newark, DE 19718-2200

Mailing address

200 Hygeia Dr Ste 2300
Newark, DE 19713-2049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130122000161 DE Practitioner - Physician Assistant 2860645033 Reassigns benefits to 1 organization
I20211220001502 MD Practitioner - Physician Assistant 2860645033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christiana Care Health Services IncGroup PAC ID 9739097569, 1,480 clinicians

Practice addresses (Care Compare)

4755 Ogletown Stanton Rd
Newark, DE 19718-2200

501 W 14TH St
Wilmington, DE 19801-1013

501 W 14TH St FL
6 CCHS Infectious Disease
Wilmington, DE 19801-1013
Phone (302) 320-1300

501 W 14TH St Wilmington Hospital
Wilmington, DE 19801-1013

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA050950PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Health Services Inc CurrentSince Mar 14, 2016 Accepting new patients
Union Hospital of Cecil County CurrentSince Oct 20, 2021 Accepting new patients
Christiana Care Health Services, Inc Physician Assistant CurrentSince Mar 14, 2016 Accepting new patients
Union Hospital of Cecil County, Inc. Physician Assistant CurrentSince Oct 20, 2021 Accepting new patients
Christiana Care Health Services, Inc Physician Assistant Past Accepting new patients

Locations

200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362

4701 Ogletown Stanton Rd
Ste 1500
Newark, DE 19713
Phone (302) 623-4343

4755 Ogletown Stanton Rd
Ste 2670
Newark, DE 19718
Phone (302) 584-2601

1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440

207 North St
Elkton, MD 21921
Phone (410) 996-8700

106 Bow St
Elkton, MD 21921
Phone (410) 298-2000

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1209772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1588830194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DR STE 2300",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN STANTON RD STE 2670",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERIN",
        "first_name": "JUSTIN",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-03",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA050950",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0005942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.