Individual provider Active NPI

Jose Miguel Lares-Guia, MD

  • General Practice Physician
  • New York, NY
National Provider Identifier
1902030869
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
249492 Issued in NY
Practice address
111 Wadsworth Ave
New York, NY 10033-6102
Phone
(646) 682-7544
Fax
(646) 666-0339
NPI assigned
May 7, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 249492 NY Primary

Addresses

Primary practice location

111 Wadsworth Ave
New York, NY 10033-6102

Mailing address

111 Wadsworth Ave
New York, NY 10033-6102
Phone (646) 682-7544

Other identifiers 3

IdentifierTypeStateIssuer
03161662MedicaidNY
03161662-03OtherNYADAP
249492OtherNYMEDICAL LICENSE

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
I20100812000404 NY Practitioner - General Practice 4486788460 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Ace Medical Care PCGroup PAC ID 6608181979, 2 clinicians

Practice addresses (Care Compare)

111 Wadsworth Ave
New York, NY 10033-6102
Phone (646) 682-7544

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ace Medical Care PC CurrentSince Apr 24, 2025 Accepting new patients
Patrick Dalton MD PC Past Accepting new patients
Paul Curtis. Bellman , M.D., P.C. Past Accepting new patients

Locations

111 Wadsworth Ave
New York, NY 10033
Phone (212) 740-7400

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": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1902030869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WADSWORTH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336102",
            "telephone_number": "646-682-7544",
            "fax_number": "646-666-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WADSWORTH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336102",
            "telephone_number": "646-682-7544",
            "fax_number": "646-666-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARES-GUIA",
        "first_name": "JOSE",
        "middle_name": "MIGUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "249492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03161662",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADAP",
            "identifier": "03161662-03",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "249492",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.