Individual provider Active NPI

Carmelita T Deguzman, M.D.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1710918966
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD037835L Issued in PA
Practice address
7600 Central Ave
Philadelphia, PA 19111-2442
Phone
(215) 728-2000
Fax
(215) 214-4119
NPI assigned
Jul 5, 2006
Last updated
Jan 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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 MD037835L PA Primary

Addresses

Primary practice location

7600 Central Ave
Philadelphia, PA 19111-2442

Mailing address

PO Box 820933
Philadelphia, PA 19182-0933
Phone (215) 728-2000

Other identifiers 3

IdentifierTypeStateIssuer
1007278000OtherPAMEDICAID GROUP TPI
597586OtherPAMEDICARE GROUP TPI
CD4829OtherPARAIL ROAD MEDICARE GROUP TPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Physicians Inc Past Accepting new patients
Executive Health Resources Clinical Staffing Solutions PC Past Accepting new patients
Burholme Emergency Care Specialists LLC Past Accepting new patients
Temple Physicians Inc Past Accepting new patients
Temple Physicians Inc Past Accepting new patients
Temple Physicians Inc Family Medicine Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1710918966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-728-2000",
            "fax_number": "215-214-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 CENTRAL AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112442",
            "telephone_number": "215-728-2000",
            "fax_number": "215-214-4119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGUZMAN",
        "first_name": "CARMELITA",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD037835L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP TPI",
            "identifier": "1007278000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP TPI",
            "identifier": "597586",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE GROUP TPI",
            "identifier": "CD4829",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.