Individual provider Active NPI

Jorge R Guevara, MD

  • Internal Medicine Physician
  • Brownsville, TX
National Provider Identifier
1629040654
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MDJ9070 Issued in TX
Practice address
425 E Los Ebanos Blvd
Ste 100
Brownsville, TX 78520
Phone
(956) 546-3116
Fax
(956) 546-8793
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X 612448 TX
Internal Medicine Physician 207R00000X MDJ9070 TX Primary

Addresses

Primary practice location

425 E Los Ebanos Blvd
Ste 100
Brownsville, TX 78520

Mailing address

PO Box 4650
Brownsville, TX 78523-4650
Phone (956) 546-3116

Other identifiers 1

IdentifierTypeStateIssuer
137955412MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100305000819 TX Practitioner - Internal Medicine 0143290080 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

425 E Los Ebanos Blvd
Suite 100
Brownsville, TX 78520-8482
Phone (956) 546-3116

Hospital & facility affiliations

  • Dream Care LLC Home health agency, Brownsville, TX, CCN 679503
  • Christian Quality Home Health Care Inc Home health agency, Harlingen, TX, CCN 679438
  • Valley Baptist Medical Center- Brownsville Hospital, Brownsville, TX, CCN 450028
  • Valley Regional Medical Center Hospital, Brownsville, TX, CCN 450662
  • Mesa Hills Post Acute Nursing home, Brownsville, TX, CCN 455423

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDJ9070TXMDInternal Medicine Physician
612448TXMDAddiction Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Outcomes Detox Center, LLC CurrentSince Oct 26, 2018 Accepting new patients
Medical Associates of Brownsville PA Internal Medicine CurrentSince Nov 2, 1999 Accepting new patients
VHS Brownsville Hospital Company LLC Past Accepting new patients
Liberty County Hospital District No 1 Past Accepting new patients
Columbia Valley Healthcare System, L.P. Past Accepting new patients

Locations

425 E Los Ebanos Blvd
Ste 104
Brownsville, TX 78520
Phone (956) 542-2520

425 E Los Ebanos Blvd
Ste 108109
Brownsville, TX 78520
Phone 9565463116250

425 E Los Ebanos Blvd
Ste 100
Brownsville, TX 78520
Phone (956) 546-3116

95 E Price Rd
Bldg D
Brownsville, TX 78521
Phone (956) 546-3116

3808 Padre Blvd
South Padre Island, TX 78597
Phone (956) 546-3116

Interoperability endpoints

  • Direct secure messaging: jorge.guevara@maob.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EIBBAA/Endpoint/EIBBAA

Organizations & group practices 5

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 5

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1629040654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4650",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785234650",
            "telephone_number": "956-546-3116",
            "fax_number": "956-546-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E LOS EBANOS BLVD",
            "address_2": "STE 100",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "78520",
            "telephone_number": "956-546-3116",
            "fax_number": "956-546-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "JORGE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "TX",
            "license": "612448",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "MDJ9070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137955412",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.