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RAFAEL RAYMUND CUESTA GUERRERO
NPI 1205525045
Nurse Practitioner in Bayville, NJ

Active since May 08, 2023PECOS EnrolledAccepts Medicare Assignment
53 PELICAN DRIVE, BAYVILLE, NJ 08721(732) 930-4221 Get Directions Write a Review

NPPES record last updated: December 13, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 13, 2023, May 8, 2023 (2 updates tracked since 2023).

About Rafael Raymund Cuesta Guerrero NPPES

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

RAFAEL RAYMUND CUESTA GUERRERO (NPI 1205525045) is an individual nurse practitioner in Bayville, New Jersey, licensed in New Jersey (26NJ01478900) and active in the NPI registry since May 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mount Holly, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1205525045
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameRAFAEL RAYMUND CUESTA GUERRERO
Location Address53 PELICAN DRIVEBayville, NJ 08721
Mailing Address53 Pelican DriveBayville, NJ 08721 · (732) 930-4221
Phone(732) 930-4221
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateMay 8, 2023
Last NPPES UpdateDecember 13, 20232 updates tracked since enumeration
NPPES CertifiedDecember 13, 2023
✔ NPI 1205525045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in NJ · 26NJ01478900
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
53 PELICAN DRIVE, Bayville, NJ 08721
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Secondary Practice Location 1

Location 1137 High St Fl 2AMount Holly, NJ 08060-1476 · Phone (609) 474-0120

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.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

Rafael Raymund Cuesta Guerrero 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 ID3274996921
PECOS Enrollment IDI20230828003264
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

5

Medicare enrollment records show Rafael Raymund Guerrero reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Botox And Family Associates LLC
4.1 mi
Geriatric Medicine
20 HOSPITAL DR
Toms River, NJ 08755
  • Reassigned Medicare billing, New Jersey enrollment
  • 7 clinicians in this Medicare group
NPI 1235614744 (732) 341-9900
Ocean Family & Geriatric Associates LLC
4.1 mi
Internal Medicine
20 HOSPITAL DRIVE SUITE 3
Toms River, NJ 08753
  • Reassigned Medicare billing, New Jersey enrollment
  • 15 clinicians in this Medicare group
NPI 1740321645 (732) 341-9900
Vinod Sancheti Mdpa
5.2 mi
Family Medicine
25 MULE RD UNIT B8
Toms River, NJ 08755
  • Reassigned Medicare billing, New Jersey enrollment
  • 6 clinicians in this Medicare group
NPI 1891820304 (732) 240-4000
Clare Medical Of New Jersey LLC
33 mi
Geriatric Medicine
137 HIGH ST FL 2A
Mount Holly, NJ 08060
  • Reassigned Medicare billing, New Jersey enrollment
  • 56 clinicians in this Medicare group
NPI 1255718276 (609) 474-0120
Signify Health Medical Associates Of New Jersey, LLC
41 mi
General Practice
116 VILLAGE BLVD STE 200
Princeton, NJ 08540
  • Reassigned Medicare billing, New Jersey enrollment
  • 421 clinicians in this Medicare group
NPI 1174187728 (877) 868-5351

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.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
162 services104 patients
Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350
An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.
57 services48 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
47 services19 patients
Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes 99344
A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.
47 services47 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
27 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08721 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
$94.90 typical visit price
range $61.59 – $185.05
Typical copayment $23.72 (range $15.39 – $46.26)
Most-billed visit code 99203
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

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 Rafael Raymund Guerrero's NPI number?

The NPI number for Rafael Raymund Guerrero is 1205525045. It was assigned to this individual provider in the NPPES registry on May 8, 2023.

Where is Rafael Raymund Guerrero located?

Rafael Raymund Guerrero practices at 53 Pelican Drive, Bayville, NJ 08721. The listed phone number is (732) 930-4221.

What is Rafael Raymund Guerrero's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Rafael Raymund Guerrero enrolled in Medicare?

Yes. Rafael Raymund Guerrero 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 Rafael Raymund Guerrero's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rafael Raymund Guerrero reassigns Medicare benefits to 5 organizations: Botox And Family Associates LLC (Toms River, NJ), Ocean Family & Geriatric Associates LLC (Toms River, NJ), Vinod Sancheti Mdpa (Toms River, NJ), Clare Medical Of New Jersey LLC (Mount Holly, NJ) and Signify Health Medical Associates Of New Jersey, LLC (Princeton, NJ). 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 Rafael Raymund Guerrero's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Rafael Raymund Guerrero accept?

Health plans from Oscar Health list Rafael Raymund Guerrero 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 Rafael Raymund Guerrero was last updated on December 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.