Active NPI
Jose Lares-Guia Physician PC
- General Practice Physician
- New York, NY
National Provider Identifier
1760816367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- JOSE LARES-GUIA PHYSICIAN PC
- Practice address
- 84 Grove St Apt 3
New York, NY 10014-3566 - Phone
- (646) 429-5555
- Fax
- (678) 553-1274
- NPI assigned
- Aug 30, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jose M Lares-Guia, MD
- Title
- Sole Proprietor
- Phone
- (917) 613-6030
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
84 Grove St Apt 3
New York, NY 10014-3566
Mailing address
84 Grove St Apt 3
New York, NY 10014-3566
Phone (646) 429-9555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03161662 | Medicaid | NY |
National Provider Directory
National Provider DirectoryLocations
1123 Broadway
Ste 1017
New York, NY 10010
Phone (347) 696-7009
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- New York, NY
- NPI 1356475826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377820800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710547200000",
"number": "1760816367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 GROVE ST APT 3",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100143566",
"telephone_number": "646-429-9555",
"fax_number": "646-429-9555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 GROVE ST APT 3",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100143566",
"telephone_number": "646-429-5555",
"fax_number": "678-553-1274"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOSE LARES-GUIA PHYSICIAN PC",
"organizational_subpart": "NO",
"enumeration_date": "2013-08-30",
"last_updated": "2024-03-16",
"certification_date": "2024-03-04",
"status": "A",
"authorized_official_last_name": "LARES-GUIA",
"authorized_official_first_name": "JOSE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "SOLE PROPRIETOR",
"authorized_official_telephone_number": "917-613-6030",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03161662",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.