Individual provider Active NPI

Rafael A. Guillen, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1861430076
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
233234 Issued in NY
Practice address
800 Grand Concourse FRNT Office5
Bronx, NY 10451-3003
Phone
(718) 401-2300
Fax
(718) 401-2322
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 233234 NY Primary

Addresses

Primary practice location

800 Grand Concourse FRNT Office5
Bronx, NY 10451-3003

Mailing address

800 Grand Concourse FRNT Office5
Bronx, NY 10451-3003
Phone (718) 401-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20050314000683 NY Practitioner - Internal Medicine 6901851807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3722 82ND St
Jackson Heights, NY 11372-7040
Phone (718) 879-1600

800 Grand Concourse
FRNT Office5
Bronx, NY 10451-3003
Phone (718) 401-2300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233234NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine Internal Medicine CurrentSince Feb 1, 2020 Accepting new patients
R Guillen MD PC CurrentSince Nov 7, 2007 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Internal Medicine CurrentSince Feb 1, 2020 Accepting new patients
Broadway Cardiopulmonary, P.C. Internal Medicine Past Accepting new patients

Locations

800 Grand Concourse
Frnt 5
Bronx, NY 10451
Phone (718) 401-2300

509 Willis Ave
Fl 4
Bronx, NY 10455
Phone (718) 201-2300

3712 82nd St
Jackson Hts, NY 11372
Phone (718) 879-1600

3722 82nd St
Jackson Hts, NY 11372
Phone (718) 779-1600

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BHIFAA/Endpoint/BHIFAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1861430076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 GRAND CONCOURSE FRNT OFFICE5",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513003",
            "telephone_number": "718-401-2300",
            "fax_number": "718-401-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 GRAND CONCOURSE FRNT OFFICE5",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104513003",
            "telephone_number": "718-401-2300",
            "fax_number": "718-401-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLEN",
        "first_name": "RAFAEL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "233234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.