Edwin Orlando Guerra, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12274 Issued in TX

Practice address

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520

Phone

(806) 744-7223

NPI assigned

Sep 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Texas Tech University Health Science Center School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grace Clinic of LubbockGroup PAC ID 5597768101, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grace Surgical Hospital Hospital, Lubbock, TX, CCN 450162

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Grace Clinic of Lubbock

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1912953357
  Medicare reassignment Care Compare group
• Grace Clinic of Lubbock

  • Multi-Specialty Clinic/Center
  • Lubbock, TX
  • NPI 1770237042
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lubbock Heritage Hospital, LLC.

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1225289499
  Care Compare affiliation

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1760967640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA",
        "first_name": "EDWIN",
        "middle_name": "ORLANDO",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-26",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eguerra1396642@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4515 Marsha Sharp Fwy",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794072520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dallin Thayne Grover, DPT
• Stephen Luke Grupke, MD, MS
• Jingjing Guan
• Mateo Guardiola, MD
• Cynthia Michelle Guerin, MD
• Julius Gregory Guerra, MSN, APRN, ACNPC-AG
• Natalie Guerra
• Andrea Guerrero
• Carlos Guerrero, LPC
• Amanda Malouf Guetersloh, MD

• Physician Assistant in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.