Individual provider Active NPI

Rock H. Jean-Guillaume, D.O.

  • Emergency Medicine Physician
  • Holden, MA
National Provider Identifier
1730157918
Registry record updated Nov 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
215241 Issued in MA
Practice address
5 Shrewsbury St Ste D
Holden, MA 01520
Phone
(508) 829-3800
Fax
(508) 829-3802
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 215241 MA Primary

Addresses

Primary practice location

5 Shrewsbury St Ste D
Holden, MA 01520

Mailing address

5 Shrewsbury St Ste D
Holden, MA 01520-1960
Phone (508) 829-3810

Other practice location 1

2040 Boston Rd Ste 5
Wilbraham, MA 01095-1380
Phone (413) 599-3800

Other practice location 2

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 421-1400

Other identifiers 1

IdentifierTypeStateIssuer
110006102AMedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rjeanguillaume21197@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040409000056 MA Practitioner - Emergency Medicine 8426042839 Reassigns benefits to 3 organizations
I20200729000554 SC Practitioner - Emergency Medicine 8426042839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

107 McLeod Health Blvd
Myrtle Beach, SC 29579-4477
Phone (843) 646-8001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215241MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Oct 1, 2019 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Oct 1, 2019 Accepting new patients
Conway Hospital Emergency Professional Services Emergency Medicine CurrentSince Jul 27, 2021 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Apr 1, 2020 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Emergency Medicine CurrentSince Oct 1, 2019 Accepting new patients
Urgent Care Specialists PC Emergency Medicine Past Accepting new patients

Locations

1 Deaconess Rd
Boston, MA 02215
Phone (617) 754-2323

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

107 McLeod Health Blvd
Myrtle Beach, SC 29579
Phone (843) 646-8001

Interoperability endpoints

  • Direct secure messaging: rjeanguillaume25370@directmcleodehealth.org
  • Direct secure messaging: rjeanguillaume21197@umassmemorial.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1730157918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SHREWSBURY ST STE D",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015201960",
            "telephone_number": "508-829-3810",
            "fax_number": "508-829-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SHREWSBURY ST STE D",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "01520",
            "telephone_number": "508-829-3800",
            "fax_number": "508-829-3802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 Boston Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Wilbraham",
            "state": "MA",
            "postal_code": "010951380",
            "country_code": "US",
            "telephone_number": "413-599-3800",
            "fax_number": "413-279-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEAN-GUILLAUME",
        "first_name": "ROCK",
        "middle_name": "H.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "215241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110006102A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rjeanguillaume21197@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Holden, MA

Sources for this page

Verify at the official NPI Registry.