Individual provider Active NPI

Madison Wisconsin Guevara, MD

  • Student in an Organized Health Care Education/Training Program
  • Albuquerque, NM
National Provider Identifier
1750967444
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Msc08 4640
1 University of New Mexico
Albuquerque, NM 87131
Phone
(505) 272-4814
Fax
(505) 272-0240
NPI assigned
Mar 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TL0008564 CO
Student in an Organized Health Care Education/Training Program 390200000X NM Primary

Addresses

Primary practice location

Msc08 4640
1 University of New Mexico
Albuquerque, NM 87131

Mailing address

Msc08 4640
1 University of New Mexico
Albuquerque, NM 87131
Phone (505) 272-4814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TL0008564COMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1750967444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC08 4640",
            "address_2": "1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87131",
            "telephone_number": "505-272-4814",
            "fax_number": "505-272-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC08 4640",
            "address_2": "1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87131",
            "telephone_number": "505-272-4814",
            "fax_number": "505-272-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "MADISON",
        "middle_name": "WISCONSIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CO",
            "license": "TL0008564",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.