Individual provider Active NPI

Sophia N Guevara, PA

  • Physician Assistant
  • Bronx, NY
National Provider Identifier
1891863916
Registry record updated Mar 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
011044 Issued in NY
Practice address
2293 Loring PL N
Bronx, NY 10468-5800
Phone
(646) 302-1676
NPI assigned
Nov 30, 2006
Last updated
Mar 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 011044 NY Primary
Surgical Physician Assistant 363AS0400X 011044 NY

Addresses

Primary practice location

2293 Loring PL N
Bronx, NY 10468-5800

Mailing address

2293 Loring PL N
Bronx, NY 10468-5800
Phone (646) 302-1676

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150507000673 NY Practitioner - Physician Assistant 0446354708 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

153 E 125TH St
New York, NY 10035-1748
Phone (929) 476-0460

336 E 86TH St
New York, NY 10028-4615
Phone (212) 772-3627

617 W 181St St
New York, NY 10033-4937
Phone (646) 346-7922

80 W 125TH St
New York, NY 10027-4502
Phone (212) 609-2545

Merit-based Incentive Payment System (MIPS)

Final score
86.33 of 100Reported as group
Quality
82.1
Promoting interoperability
100
Improvement activities
40
Cost
72.34

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
011044NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince May 13, 2024 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince May 13, 2024 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Interoperability endpoints

  • Direct secure messaging: sophia.guevara.2@2983.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425513600000",
    "number": "1891863916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2293 LORING PL N",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104685800",
            "telephone_number": "646-302-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2293 LORING PL N",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104685800",
            "telephone_number": "646-302-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARA",
        "first_name": "SOPHIA",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2015-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011044",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "011044",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.