Individual provider Active NPI

Ramon R. De Guzman, M.D.

  • Diagnostic Radiology Physician
  • Sartell, MN
National Provider Identifier
1790879575
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
51689 Issued in MN
Practice address
166 19TH Street South
Suite 100
Sartell, MN 56377-2154
Phone
(320) 251-0609
Fax
(320) 251-3806
NPI assigned
Oct 3, 2006
Last updated
Mar 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 35.088582 OH
Diagnostic Radiology Physician 2085R0202X 51689 MN Primary

Addresses

Primary practice location

166 19TH Street South
Suite 100
Sartell, MN 56377-2154

Mailing address

PO Box 1450 NW 6035
Minneapolis, MN 55485-6035
Phone (952) 542-8553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20090610000561 MN Practitioner - Diagnostic Radiology 0446300594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Scanning Consultants PAGroup PAC ID 9032005376, 82 clinicians

Practice addresses (Care Compare)

155 Dehler Dr
Sartell, MN 56377-4407
Phone (320) 251-0609

1901 Connecticut Ave S
Suite 200
Sartell, MN 56377-2554
Phone (320) 251-0609

251 County Rd
120 Suite D
Sartell, MN 56303-4897
Phone (320) 251-0609

3260 42ND Ave S
Suite 101
Saint Cloud, MN 56301-6251
Phone (320) 251-0609

5775 Wayzata Blvd
Suite 190
St Louis Park, MN 55416-2627
Phone (952) 541-1840

9040 Quaday Ave NE
Suite 100
Otsego, MN 55330-6657
Phone (763) 433-2033

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.088582OHMDNeuroradiology Physician
51689MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cdi Twin Cities ASC LLC Current Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince May 1, 2009 Accepting new patients
Medical Scanning Consultants PA Diagnostic Radiology CurrentSince May 1, 2009 Accepting new patients

Locations

166 19th St S
Ste 100
Sartell, MN 56377

5775 Wayzata Blvd
Ste 190
St Louis Park, MN 55416
Phone (952) 525-6338

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1790879575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1450 NW 6035",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554856035",
            "telephone_number": "952-542-8553",
            "fax_number": "952-513-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 19TH STREET SOUTH",
            "address_2": "SUITE 100",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772154",
            "telephone_number": "320-251-0609",
            "fax_number": "320-251-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GUZMAN",
        "first_name": "RAMON",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "OH",
            "license": "35.088582",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "51689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.