Individual provider Active NPI

Carolina Trevino Guajardo, M.D.

  • Specialist
  • Glen Burnie, MD
National Provider Identifier
1891140646
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0092100 Issued in MD
Practice address
802 Landmark Dr Ste 119
Glen Burnie, MD 21061-9121
Phone
(410) 760-8840
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D0092100 MD
Specialist 174400000X D0092100 MD Primary

Addresses

Primary practice location

802 Landmark Dr Ste 119
Glen Burnie, MD 21061-9121

Mailing address

802 Landmark Dr
Ste 119
Glen Burnie, MD 21061-9121
Phone (410) 760-8840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20210819003131 MD Practitioner - Otolaryngology 7618268681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

802 Landmark Dr
Suite 119
Glen Burnie, MD 21061-9121
Phone (410) 760-8840

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.02 of 100Reported as group
Quality
65.13
Promoting interoperability
98
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0092100MDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins Regional Physicians LLC CurrentSince Aug 30, 2021 Accepting new patients
Johns Hopkins Regional Physicians LLC Current Accepting new patients
Johns Hopkins Regional Physicians LLC CurrentSince Aug 30, 2021 Accepting new patients
Johns Hopkins Regional Physicians LLC Otolaryngology Past Accepting new patients

Locations

11085 Little Patuxent Pkwy
Ste 101
Columbia, MD 21044
Phone (410) 997-7979

10710 Charter Dr
Ste 400
Columbia, MD 21044
Phone (410) 997-7979

802 Landmark Dr
Ste 119
Glen Burnie, MD 21061
Phone 4107608840203

1300 York Rd
Ste 30D
Lutherville Timonium, MD 21093
Phone (443) 275-1337

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.

Hospital & facility affiliations 2

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": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1891140646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR",
            "address_2": "STE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210619121",
            "telephone_number": "410-760-8840",
            "fax_number": "410-367-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 LANDMARK DR STE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210619121",
            "telephone_number": "410-760-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO GUAJARDO",
        "first_name": "CAROLINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2021-10-01",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0092100",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0092100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.