Individual provider Active NPI

Karla De Guzman Wang, PA-C

  • Physician Assistant
  • Tamuning, GU
National Provider Identifier
1932886587
Registry record updated Apr 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
851 Gov Carlos G Camacho Rd
Tamuning, GU 96913-3153
Phone
(671) 649-5018
NPI assigned
Jul 4, 2023
Last updated
Apr 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

851 Gov Carlos G Camacho Rd
Tamuning, GU 96913-3153

Mailing address

851 Gov Carlos G Camacho Rd
Tamuning, GU 96913-3153
Phone (671) 649-5018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
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
I20241023000015 GU Practitioner - Physician Assistant 9032642541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Doctors ClinicGroup PAC ID 3779472584, 3 clinicians

Practice addresses (Care Compare)

851 Gov Carlos Camacho Rd
Tamuning, GU 96913-3153
Phone (671) 988-6974

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Doctors' Clinic Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714262400000",
    "number": "1932886587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 GOV CARLOS G CAMACHO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133153",
            "telephone_number": "671-649-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 GOV CARLOS G CAMACHO RD",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133153",
            "telephone_number": "671-649-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "KARLA",
        "middle_name": "DE GUZMAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-04",
        "last_updated": "2024-04-28",
        "certification_date": "2024-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.