NPIMap

Individual provider Active NPI

Ian Manuel Guerrero Corpus, M.D.

  • Family Medicine Physician
  • Blaine, MN
National Provider Identifier
1932412970
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
58740 Issued in MN
Practice address
3437 125TH Dr NE Unit C
Blaine, MN 55449-6139
Phone
(701) 341-1780
Fax
(701) 341-1780
NPI assigned
Jul 20, 2010
Last updated
Oct 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 58740 MN Primary

Addresses

Primary practice location

3437 125TH Dr NE Unit C
Blaine, MN 55449-6139

Mailing address

90 Cypress E Way 10
Naples, FL 34110-9275
Phone (239) 431-7906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151028001905 FL Practitioner - Family Practice 3971784067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Moorings IncorporatedGroup PAC ID 4688832066, shared by 2 NPIs, 116 clinicians
Hospitalist Medicine Physicians of Mississippi-TCG, Inc.Group PAC ID 2961881503, 14 clinicians
M and H Med Housecalls LLCGroup PAC ID 2961750146, 24 clinicians

Practice addresses (Care Compare)

120 Moorings Park Dr
Naples, FL 34105-2122

130 Moorings Park Dr
Naples, FL 34105-2122

1333 Santa Barbara Blvd
Cape Coral, FL 33991-2803
Phone (239) 772-1333

1407 Viscaya Pkwy
Suite 2
Cape Coral, FL 33990-6200
Phone (407) 647-2346

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Mississippi-TCG, Inc. Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
M & H Med Housecalls, LLC CurrentSince Jun 1, 2018 Accepting new patients

Locations

305 E Oak St
Apopka, FL 32703
Phone (407) 880-2265

1407 Viscaya Pkwy
Ste 2
Cape Coral, FL 33990
Phone (239) 772-0111

701 Lake Port Blvd
Leesburg, FL 34748
Phone (352) 728-3366

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Solaris Healthcare ImperialNaples, FL, CCN 105738 Skilled nursing facility Adp of the SNF May 1, 2022
Oakton Place Health and Rehabilitation at the ArlingtonNaples, FL, CCN 106108 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2024
Feb 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1932412970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 CYPRESS E WAY 10",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341109275",
            "telephone_number": "239-431-7906",
            "fax_number": "239-597-0338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3437 125TH DR NE UNIT C",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496139",
            "telephone_number": "701-341-1780",
            "fax_number": "701-341-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORPUS",
        "first_name": "IAN MANUEL",
        "middle_name": "GUERRERO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "58740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

Verify at the official NPI Registry.