Marivic Badilla Guanso, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP11495 Issued in AZ

Practice address

6820 E Brown Rd
Mesa, AZ 85207

Phone

(480) 718-1285

Fax

(602) 830-6014

NPI assigned

Aug 9, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group Arizona LLCGroup PAC ID 3173872835, 152 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marivic.guanso.1@19654.direct.athenahealth.com
• Direct secure messaging: mguanso@hmg.gwaydirect.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.

• Summit Medical Group Arizona LLC

  • Family Medicine Physician
  • Glendale, AZ
  • NPI 1053810622
  Medicare reassignment Care Compare group NPD
• Charina Tecson MD PC

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1689896094
  NPD (past)

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1669951729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852073705",
            "telephone_number": "480-718-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85207",
            "telephone_number": "480-718-1285",
            "fax_number": "602-830-6014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUANSO",
        "first_name": "MARIVIC",
        "middle_name": "BADILLA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Curtis Grubbs, CRNA
• Jordan L Grubbs
• Martin J Gruenberg, DO
• Hope Esther Grunow, MS CCC SPEECH LANGUA
• GS Consulting Services, LLC
• Guardian Angel Care Transportation
• Guardian Angels Home Health LLC
• Guardian Angels Hospice LLC
• Samantha Gubka, MS OTR/L
• Talia Shumway Gubler, RDH

• Family Nurse Practitioner in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.