Individual provider Active NPI

Gabriel Guardarramas, M.D.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1699754804
Registry record updated Jan 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
139951 Issued in NY
Practice address
600 W 111TH St
Suite 1E
New York, NY 10025-1813
Phone
(212) 222-1142
Fax
(212) 222-0220
NPI assigned
Jan 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 139951 NY Primary

Addresses

Primary practice location

600 W 111TH St
Suite 1E
New York, NY 10025-1813

Mailing address

600 W 111TH St
Suite 1E
New York, NY 10025-1813
Phone (212) 222-1142

Other identifiers 1

IdentifierTypeStateIssuer
004616160MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20110321000992 NY Practitioner - Family Practice 3577746072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1975
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

600 W 111TH St
1E
New York, NY 10025-1813
Phone (212) 222-1142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
139951NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Family Health Serv Inc Family Medicine CurrentSince Nov 6, 2012 Accepting new patients

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546732800000",
    "number": "1699754804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 111TH ST",
            "address_2": "SUITE 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251813",
            "telephone_number": "212-222-1142",
            "fax_number": "212-222-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W 111TH ST",
            "address_2": "SUITE 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251813",
            "telephone_number": "212-222-1142",
            "fax_number": "212-222-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUARDARRAMAS",
        "first_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-16",
        "last_updated": "2019-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "139951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004616160",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.