1. Home
  2. Directory
  3. Alaska
  4. Sitka
  5. Internal Medicine
  6. NPI Profile

DR. GUILLERMO EDUARDO ESPINOZA M.D.
NPI 1194081042
Internal Medicine in Sitka, AK

Active since April 04, 2012PECOS EnrolledAccepts Medicare Assignment
87.09/100
CMS Quality Rating
222 TONGASS DR, SITKA, AK 99835(907) 966-2411 Get Directions Write a Review

NPPES record last updated: June 24, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Guillermo Eduardo Espinoza M.d. NPPES

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

DR. GUILLERMO EDUARDO ESPINOZA M.D. (NPI 1194081042) is an individual internal medicine provider in Sitka, Alaska, licensed in Alaska (102592) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS and is a graduate of New York University School Of Medicine (2012).

NPPES Registry Identity

NPI1194081042
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. GUILLERMO EDUARDO ESPINOZACredential: M.D.
Location Address222 TONGASS DRSitka, AK 99835
Mailing Address222 Tongass DrSitka, AK 99835-9416 · (907) 966-2411
Phone(907) 966-2411
Sole ProprietorNo
Medical School CMSNew York University School Of MedicineGraduated 2012
Enumeration DateApril 4, 2012
Last NPPES UpdateJune 24, 2019
✔ NPI 1194081042 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in AK · 102592
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
222 TONGASS DR, Sitka, AK 99835
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Guillermo Eduardo Espinoza 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 ID840506556
PECOS Enrollment IDI20150826000595
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Guillermo Espinoza reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Southeast Alaska Regional Health Consortium
Same address
Critical Access
222 TONGASS DR
Sitka, AK 99835
  • Reassigned Medicare billing, Texas enrollment
  • 640 clinicians in this Medicare group
NPI 1720062524 (907) 966-2411
Alaska Native Tribal Health Consortium
586 mi
General Acute Care Hospital
4315 DIPLOMACY DR
Anchorage, AK 99508
  • Reassigned Medicare billing, Texas enrollment
  • 1,373 clinicians in this Medicare group
NPI 1437189339 (907) 563-2662

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the 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 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
74 services26 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.
60 services46 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
21 services21 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
16 services16 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.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99835 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
$168.20 typical visit price
range $71.33 – $222.64
Typical copayment $42.05 (range $17.83 – $55.66)
Most-billed visit code 99204
Established Patient
$128.73 typical visit price
range $21.84 – $181.48
Typical copayment $32.18 (range $5.46 – $45.37)
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.

87.09/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality77.43
Promoting Interoperability100
Improvement Activities40
Cost62.86

Referred Medical Equipment & Supplies CMS DME claims 7

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

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
1 supplier31 claims31 services$45.01 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
1 supplier25 claims25 services$116.07 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
1 supplier23 claims32 services$42.69 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
1 supplier23 claims23 services$23.85 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
1 supplier31 claims184 services$2.17 avg. paid by Medicare
Humidifier, heated, used with positive airway pressure device E0562
DME-Other DME · category DE001N
1 supplier21 claims21 services$182.02 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.

TERRY THOMAS CAVANAUGH PT
Physical Therapist
222 TONGASS DR
SITKA, AK 99835
Sitka City And Borough (907) 966-8312
SEARHC MT. EDGECUMBE HOSPITAL
General Acute Care Hospital (Rural)
222 TONGASS DR
SITKA, AK 99835
Sitka City And Borough (907) 966-2411
JESSICA HOLLAND
Dietitian, Registered
222 TONGASS DR
SITKA, AK 99835
Sitka City And Borough (907) 966-2411
DR. SUL ROSS OLEN THORWARD MD
Psychiatry & Neurology (Psychiatry)
222 TONGASS DR, SEARHC CLINIC II
SITKA, AK 99835
Sitka City And Borough (907) 966-8611
DR. MARK PERRY D.D.S.
Dentist (General Practice)
222 TONGASS DR
SITKA, AK 99835
Sitka City And Borough (907) 463-4005
ASHLEY MCCOY M.S. CCC-SLP
Speech-Language Pathologist
222 TONGASS DR
SITKA, AK 99835
Sitka City And Borough (907) 966-8318
GREGORY DAVID POWELL
Counselor (Mental Health)
222 TONGASS DR
SITKA, AK 99835
Sitka City And Borough (907) 738-8834
DR. STEPHEN PAUL RILEY JR. PHARMD
Pharmacist
222 TONGASS DR
SITKA, AK 99835
Sitka City And Borough (907) 966-8347

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Guillermo Espinoza's NPI number?

The NPI number for Guillermo Espinoza is 1194081042. It was assigned to this individual provider in the NPPES registry on April 4, 2012.

Where is Guillermo Espinoza located?

Guillermo Espinoza practices at 222 Tongass Dr, Sitka, AK 99835. The listed phone number is (907) 966-2411.

What is Guillermo Espinoza's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Guillermo Espinoza enrolled in Medicare?

Yes. Guillermo Espinoza is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Guillermo Espinoza's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Guillermo Espinoza reassigns Medicare benefits to 2 organizations: Southeast Alaska Regional Health Consortium (Sitka, AK) and Alaska Native Tribal Health Consortium (Anchorage, AK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Guillermo Espinoza's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Guillermo Espinoza accept?

Health plans from Moda Health Plan, Inc. and Premera Blue Cross Blue Shield of Alaska list Guillermo Espinoza as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Guillermo Espinoza was last updated on June 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.