Mohinder K Guram, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

161456 Issued in NY

Practice address

640 Hawkins Ave
Lake Ronkonkoma, NY 11779-2324

Phone

(631) 737-0100

Fax

(631) 417-1117

NPI assigned

May 19, 2006

Last updated

Sep 12, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4

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.

• Advantagecare Physicians PC

  dba AdvantageCare Physicians

  • General Practice Physician
  • New York, NY
  • NPI 1336578772
  Medicare reassignment NPD
• Advantagecare Physicians PC

  dba AdvantageCare Physicians Urgent Care

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1063954113
  NPD

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1871546812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST",
            "address_2": "2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 HAWKINS AVE",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792324",
            "telephone_number": "631-737-0100",
            "fax_number": "631-417-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURAM",
        "first_name": "MOHINDER",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "161456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01352854",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• GNLC Physical Therapy PLLC
• Wilson Gonzalez
• Kristy A Goodman, PT
• Paris Andressi Green
• Hayley Beth Gruber
• Greg Hackett, LMHC
• Alexa Renee Haemer, PA
• Kerri Hamilton, P.T.
• Matthew James Hassel, PT, DPT
• David I Hauer, MD

• Pediatrics Physician in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.