Individual provider Active NPI

Alain A. Le Guillou, M.D.

  • Pediatrics Physician
  • Larchmont, NY
National Provider Identifier
1982742565
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
199443 Issued in NY
Practice address
2039 Palmer Ave
Suite 203
Larchmont, NY 10538-2483
Phone
(914) 834-1590
Fax
(914) 315-6225
NPI assigned
Feb 3, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 199443 NY Primary

Addresses

Primary practice location

2039 Palmer Ave
Suite 203
Larchmont, NY 10538-2483

Mailing address

2039 Palmer Ave
Suite 203
Larchmont, NY 10538-2483
Phone (914) 834-1590

Other identifiers 1

IdentifierTypeStateIssuer
199443OtherNYNY STATE 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
I20230417001599 NY Practitioner - Pediatric Medicine 2062887409 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
199443NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Children's Health Physicians, LLP Pediatrics CurrentSince Jan 11, 2023 Accepting new patients
Boston Childrens Health Physicians LLP CurrentSince Jan 11, 2023 Accepting new patients

Locations

19 Bradhurst Ave
Hawthorne, NY 10532
Phone (914) 493-7235

2039 Palmer Ave
Ste 203
Larchmont, NY 10538
Phone (212) 812-0788

400 Columbus Ave
Ste 200E
Valhalla, NY 10595
Phone (314) 400-4416

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: alain.leguillou.p1@direct.cwpw.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1982742565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 PALMER AVE",
            "address_2": "SUITE 203",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105382483",
            "telephone_number": "914-834-1590",
            "fax_number": "914-315-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2039 PALMER AVE",
            "address_2": "SUITE 203",
            "city": "LARCHMONT",
            "state": "NY",
            "postal_code": "105382483",
            "telephone_number": "914-834-1590",
            "fax_number": "914-315-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE GUILLOU",
        "first_name": "ALAIN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "199443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "199443",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Larchmont, NY

Sources for this page

Verify at the official NPI Registry.