Individual provider Active NPI

Pearl Guerzon, M.D.

  • Family Medicine Physician
  • New York, NY
National Provider Identifier
1851599765
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
233191 Issued in MA
Practice address
632 Broadway PH
New York, NY 10012-2614
Phone
(800) 731-4254
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 233191 MA Primary

Addresses

Primary practice location

632 Broadway PH
New York, NY 10012-2614

Mailing address

632 Broadway PH
New York, NY 10012-2614
Phone (800) 731-4254

Other practice location 1

281 Lincoln St
Medical Staff Services
Worcester, MA 01605-2138
Phone (508) 334-8015

Other practice location 2

Pearl Guerzon MD
4 Brighton Rd, Suite 208
Clifton, NJ 07012-0701
Phone (973) 321-9884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CT, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230411002276 TX Practitioner - Family Practice 7416140124 Reassigns benefits to 1 organization
I20241126002605 CT Practitioner - Family Practice 7416140124
I20241211003641 GA Practitioner - Family Practice 7416140124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reshaped PLLCGroup PAC ID 9638419765, 6 clinicians

Practice addresses (Care Compare)

2008 E Hebron Pkwy
Suite 114
Carrollton, TX 75007-1601
Phone (469) 431-0544

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233191MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reshaped PLLC CurrentSince Jan 1, 2023 Accepting new patients
Galileo Medical Group Ga, P.C. Family Medicine CurrentSince Sep 8, 2024 Accepting new patients
Major Hospital Past Accepting new patients

Locations

4300 Paces Ferry Rd SE
Ste 500
Atlanta, GA 30339
Phone (404) 496-8960

64 Bleecker St
New York, NY 10012
Phone (302) 313-1584

2008 E Hebron Pkwy
Ste 114
Carrollton, TX 75007
Phone (469) 431-0544

Interoperability endpoints

  • Direct secure messaging: pearl.guerzon.1@19284.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1851599765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "800-731-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "800-731-4254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "281 Lincoln St",
            "address_2": "Medical Staff Services",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052138",
            "country_code": "US",
            "telephone_number": "508-334-8015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Pearl Guerzon MD",
            "address_2": "4 Brighton Rd, Suite 208",
            "address_purpose": "LOCATION",
            "city": "Clifton",
            "state": "NJ",
            "postal_code": "070120701",
            "country_code": "US",
            "telephone_number": "973-321-9884",
            "fax_number": "978-645-6871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUERZON",
        "first_name": "PEARL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "233191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.