Individual provider Active NPI

Santiago Emanuel Quiles Guzman, MD

  • Pediatrics Physician
  • Yabucoa, PR
National Provider Identifier
1619499530
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
21943 Issued in PR
Practice address
41 Calle Cristobal Colon
Yabucoa, PR 00767-3324
Phone
(939) 458-0939
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 33129-R PR
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 21943 PR Primary

Addresses

Primary practice location

41 Calle Cristobal Colon
Yabucoa, PR 00767-3324

Mailing address

Ave Jupiter 86C
Bda Sandin
Vega Baja, PR 00694
Phone (787) 366-7445

Other practice location 1

Barrio Monacillos Centro Medico Rio Piedras
San Juan, PR 00935-0001
Phone (787) 480-2710

Other practice location 2

16 Calle Saturnino Rodriguez
Yabucoa, PR 00767-3533
Phone (787) 366-7445

Other identifiers 2

IdentifierTypeStateIssuer
66-0964255OtherPRIRS
038041300MedicaidPR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20240131004384 PR Practitioner - Pediatric Medicine 7719330208 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33129-RPRMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Q Pediatrics PR Single Specialty CurrentSince Dec 21, 2023 Accepting new patients

Locations

41 Calle Cristobal Colon
Yabucoa, PR 00767
Phone (787) 266-6313

Interoperability endpoints

  • Direct secure messaging: sjcsquiles@yourcarecommunity.org

Organizations & group practices 1

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1619499530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE JUPITER 86C",
            "address_2": "BDA SANDIN",
            "city": "VEGA BAJA",
            "state": "PR",
            "postal_code": "00694",
            "telephone_number": "787-366-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 CALLE CRISTOBAL COLON",
            "city": "YABUCOA",
            "state": "PR",
            "postal_code": "007673324",
            "telephone_number": "939-458-0939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Barrio Monacillos Centro Medico Rio Piedras",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "009350001",
            "country_code": "US",
            "telephone_number": "787-480-2710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16 Calle Saturnino Rodriguez",
            "address_purpose": "LOCATION",
            "city": "Yabucoa",
            "state": "PR",
            "postal_code": "007673533",
            "country_code": "US",
            "telephone_number": "787-366-7445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUILES GUZMAN",
        "first_name": "SANTIAGO",
        "middle_name": "EMANUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "33129-R",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "PR",
            "license": "21943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "66-0964255",
            "state": "PR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038041300",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yabucoa, PR

Sources for this page

Verify at the official NPI Registry.