Individual provider Active NPI

Elizabeth Soohye Guinto, D.O.

  • Psychiatry Physician
  • Fort Gordon, GA
National Provider Identifier
1992026553
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A17351 Issued in CA
Practice address
300 W Hospital Rd
Eamc
Fort Gordon, GA 30905-5741
Phone
(706) 787-8176
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DOS-1448 HI
Psychiatry Physician 2084P0800X 20A17351 CA Primary

Addresses

Primary practice location

300 W Hospital Rd
Eamc
Fort Gordon, GA 30905-5741

Mailing address

300 W Hospital Rd
Fort Gordon, GA 30905-5741
Phone (706) 787-8176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200204002767 CA Practitioner - Psychiatry 8123454493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Philadelphia College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of ColusaGroup PAC ID 3173656402, 8 clinicians

Practice addresses (Care Compare)

162 E Carson St
Colusa, CA 95932-2880
Phone (530) 458-0520

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17351CAMDAcupuncturist
20A17351CAMDPsychiatry Physician
DOS-1448HIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Nov 26, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 26, 2019 Accepting new patients
County of Colusa CurrentSince Jul 20, 2021 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

162 E Carson St
Colusa, CA 95932
Phone (530) 458-0520

4733 W Sunset Blvd
Los Angeles, CA 90027
Phone (213) 667-4784

888 S Hill Rd
Ventura, CA 93003
Phone (805) 477-6400

5601 De Soto Ave
Woodland Hls, CA 91367
Phone (818) 719-2000

Organizations & group practices 4

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1992026553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD",
            "address_2": "EAMC",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUINTO",
        "first_name": "ELIZABETH",
        "middle_name": "SOOHYE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "DOS-1448",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A17351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gordon, GA

Sources for this page

Verify at the official NPI Registry.