Active NPI
Reynalda M Deguzman, M.D.
- General Practice Physician
- Anchorage, AK
National Provider Identifier
1922218064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- AA1732
- Practice address
- 4361 Boniface Pkwy
Anchorage, AK 99504-4316 - Phone
- (907) 333-1211
- Fax
- (907) 333-8660
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | AA1732 | AK | Primary |
Addresses
Primary practice location
4361 Boniface Pkwy
Anchorage, AK 99504-4316
Mailing address
4361 Boniface Pkwy
Anchorage, AK 99504-4316
Phone (907) 333-1211
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD1732 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AA1732 | AK | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1922218064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4361 BONIFACE PKWY",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995044316",
"telephone_number": "907-333-1211",
"fax_number": "907-333-1211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4361 BONIFACE PKWY",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995044316",
"telephone_number": "907-333-1211",
"fax_number": "907-333-8660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGUZMAN",
"first_name": "REYNALDA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "AK",
"license": "AA1732",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD1732",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.