Individual provider Active NPI

Michael Z Guo, M.D.

  • Neurology Physician
  • Stony Brook, NY
National Provider Identifier
1760456461
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
222499 Issued in NY
Practice address
2500 Nesconset Hwy BLDG 5B
Stony Brook, NY 11790-2552
Phone
(631) 675-9508
Fax
(631) 675-9511
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 222499 NY Primary

Addresses

Primary practice location

2500 Nesconset Hwy BLDG 5B
Stony Brook, NY 11790-2552

Mailing address

2500 Nesconset Hwy BLDG 5B
Stony Brook, NY 11790-2552
Phone (631) 675-9508

Other identifiers 1

IdentifierTypeStateIssuer
02196041MedicaidNY

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
I20040709000882 NY Practitioner - Pain ManagementPractitioner - NeurologyPractitioner - Nephrology 5193703833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Neurology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2500 Nesconset Hwy
BLDG 5B
Stony Brook, NY 11790-2552
Phone (631) 675-9508

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Neurology of Long Island PC CurrentSince Oct 1, 2013 Accepting new patients

Locations

2500 Nesconset Hwy
Bldg 5B
Stony Brook, NY 11790
Phone (347) 804-4651

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIEDCA/Endpoint/AIEDCA

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1760456461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 5B",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902552",
            "telephone_number": "631-675-9508",
            "fax_number": "631-675-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 5B",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902552",
            "telephone_number": "631-675-9508",
            "fax_number": "631-675-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUO",
        "first_name": "MICHAEL",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "222499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02196041",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.