NPIMap

Individual provider Active NPI

Laverne D Gugino, MD

  • Clinical Neurophysiology Physician
  • Winthrop, MA
National Provider Identifier
1760465942
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
46992 Issued in MA
Practice address
119 Summit Ave
Winthrop, MA 02152
Phone
(617) 418-0478
NPI assigned
Nov 22, 2005
Last updated
Dec 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 46992 MA
Clinical Neurophysiology Physician 2084N0600X 46992 MA Primary

Addresses

Primary practice location

119 Summit Ave
Winthrop, MA 02152

Mailing address

3 Maryland Farms Ste 200
Brentwood, TN 37027-5005
Phone (615) 345-5400

Other identifiers 4

IdentifierTypeStateIssuer
6166253MedicaidMA
6165362MedicaidMA
LG58278MedicaidRI
J01021OtherMABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060106000258 MA Practitioner - Anesthesiology 1153344080 Reassigns benefits to 3 organizations
I20180731000680 MD Practitioner - Neurology 1153344080

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Medical College of Georgia School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Remote Neuromonitoring Physicians PCGroup PAC ID 1355495961, 36 clinicians
Sentient Physicians, P.C.Group PAC ID 2668764333, 37 clinicians

Practice addresses (Care Compare)

119 Summit Ave
Winthrop, MA 02152-1037
Phone (800) 348-4565

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46992MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Remote Neuromonitoring Physicians ,PC CurrentSince Apr 1, 2017 Accepting new patients
Sentient Physicians, P.C. CurrentSince Dec 4, 2016 Accepting new patients
Neuro Iom Services Inc Past Accepting new patients
Cambridge Public Health Commission Past Accepting new patients

Locations

3 Maryland Farms
Ste 200
Brentwood, TN 37027
Phone (615) 346-8733

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1760465942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARYLAND FARMS STE 200",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275005",
            "telephone_number": "615-345-5400",
            "fax_number": "888-468-6603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 SUMMIT AVE",
            "city": "WINTHROP",
            "state": "MA",
            "postal_code": "02152",
            "telephone_number": "617-418-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGINO",
        "first_name": "LAVERNE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "46992",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "MA",
            "license": "46992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6166253",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6165362",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LG58278",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J01021",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winthrop, MA

Sources for this page

Verify at the official NPI Registry.