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DANIEL GUEVARA-PINEDA M.D
NPI 1093962805
Internal Medicine - Nephrology in New Haven, CT

Active since August 22, 2008PECOS EnrolledAccepts Medicare Assignment
73.56/100
CMS Quality Rating
800 HOWARD AVE, NEW HAVEN, CT 06519(203) 785-2565 Get Directions Write a Review

NPPES record last updated: March 2, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 2, 2023, Nov 30, 2021, Oct 14, 2021 and 1 more (4 updates tracked since 2018).

About Daniel Guevara-pineda M.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DANIEL GUEVARA-PINEDA M.D (NPI 1093962805) is an individual nephrology provider in New Haven, Connecticut, licensed in Connecticut (73261) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1093962805
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameDANIEL GUEVARA-PINEDACredential: M.D
Location Address800 HOWARD AVENew Haven, CT 06519-1369
Mailing AddressPo Box 415348Boston, MA 02241-5348 · (800) 225-8885
Phone(203) 785-2565
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateAugust 22, 2008
Last NPPES UpdateMarch 2, 20234 updates tracked since enumeration
NPPES CertifiedMarch 2, 2023
✔ NPI 1093962805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Licenses✔ Licensed in CT · 73261✔ Licensed in MA · T288933
Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

800 HOWARD AVE, New Haven, CT 06519
Open in Google Maps ↗

Secondary Practice Locations 2

Location 155 Lake Ave NWorcester, MA 01655-0002 · Phone (508) 856-3155
Location 2119 Belmont StWorcester, MA 01605-2903 · Phone (508) 856-3155 · Fax (508) 856-3111

Other Identifiers 1

Medicaid110178357AMA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Daniel Guevara-pineda M.d is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5193918993
PECOS Enrollment IDI20230403000395
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
158 services54 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
75 services53 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
64 services42 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
40 services36 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
27 services22 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
24 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06519 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

73.56/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality75.84
Promoting Interoperability74
Improvement Activities40
Cost51.43

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
6 suppliers194 claims32,400 services$0.29 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
4 suppliers80 claims10,500 services$0.01 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
2 suppliers67 claims6,810 services$0.19 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
4 suppliers87 claims87 services$18.86 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
6 suppliers262 claims273 services$12.58 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SCOTT NICHOLAS GETTINGER MD
Internal Medicine (Medical Oncology)
800 HOWARD AVE, YALE PHYSICIANS BUILDING - 2ND FLOOR
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 688-4191
ANTOINETTE ZOLLO WEINSTEIN LCSW
Social Worker
800 HOWARD AVE, YALE PHYSICIANS BUILDING
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-7998
HARI ANANT DESHPANDE MD
Internal Medicine (Interventional Cardiology)
800 HOWARD AVE, YPB - 2ND FLOOR
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-4191
SUSAN M RICHMAN MD
Obstetrics & Gynecology
800 HOWARD AVE, YALE PHYSICIAN'S BUILDING, 3RD FLOOR
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-4176
KERRY S RUSSELL MD
Internal Medicine (Cardiovascular Disease)
800 HOWARD AVE, YALE PHYSICIANS' BUILDING, 2ND FLOOR
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-4114
RICHARD STEVEN BERCIK MD
Obstetrics & Gynecology (Gynecology)
800 HOWARD AVE, YALE PHYSICIANS BUILDING- 3RD FLOOR
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-4176
STEVEN PFAU MD
Internal Medicine (Cardiovascular Disease)
800 HOWARD AVE, YALE PHYSICIANS' BUILDING; DEPT. OF CARDIOLOGY
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-4191
DAMIAN MACDONALD MD
Emergency Medicine
800 HOWARD AVE, YALE PHYSICIANS BUILDING
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 785-2140

Frequently Asked Questions

What is Daniel Guevara-pineda's NPI number?

The NPI number assigned to this healthcare provider is 1093962805, enumerated as an "individual" on August 22, 2008.

Where is the provider located?

The provider is located at 800 HOWARD AVE NEW HAVEN, CT 06519 and the phone number is (203) 785-2565.

What is the provider's specialty?

Internal Medicine with taxonomy code 207RN0300X and a focus in Nephrology.

What insurance does Daniel Guevara-pineda accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.