Individual provider Active NPI

Gwen E. Guglielmi, M.D.

  • Diagnostic Radiology Physician
  • Princeton, NJ
National Provider Identifier
1851317036
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA05716400 Issued in NJ
Practice address
65 Maybury Hill Road
Princeton, NJ 08540-3617
Phone
(609) 497-0196
Fax
(732) 821-6675
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA05716400 NJ Primary

Addresses

Primary practice location

65 Maybury Hill Road
Princeton, NJ 08540-3617

Mailing address

65 Maybury Hill Road
Princeton, NJ 08540-3617
Phone (609) 497-0196

Other identifiers 1

IdentifierTypeStateIssuer
5352703MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05716400NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hillsborough Radiology Centers, LLC Diagnostic Radiology PastSince Dec 1, 2016 Accepting new patients
Radiation Oncology Consultants of Pennsylvania, PC Past Accepting new patients
Princeton Radiology Associates, P.a. Diagnostic Radiology Past Accepting new patients
Hillsborough Radiology Associates, LLC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 4

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1851317036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MAYBURY HILL ROAD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403617",
            "telephone_number": "609-497-0196",
            "fax_number": "732-821-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MAYBURY HILL ROAD",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403617",
            "telephone_number": "609-497-0196",
            "fax_number": "732-821-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGLIELMI",
        "first_name": "GWEN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA05716400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5352703",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.