Individual provider Active NPI

Stevan Guarneri

  • Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1669260584
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A185223 Issued in IA
Practice address
4500 S Lancaster Rd
Dallas, TX 75216-7167
Phone
(214) 742-8387
NPI assigned
Apr 29, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1068345 TX
Registered Nurse 163W00000X 1068345 TX
Nurse Practitioner 363L00000X A185223 IA Primary

Addresses

Primary practice location

4500 S Lancaster Rd
Dallas, TX 75216-7167

Mailing address

4500 S Lancaster Rd
Dallas, TX 75216-7167
Phone (214) 742-8387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250708003778 IA Order and Referring Only - Nurse Practitioner 8224542634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A185223IAMDNurse Practitioner
1068345TXMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1669260584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-742-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 S LANCASTER RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752167167",
            "telephone_number": "214-742-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUARNERI",
        "first_name": "STEVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1068345",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1068345",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A185223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.