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SHERWIN GUIMALAN HISONA
NPI 1235726399
Nurse Practitioner in Southgate, MI

Active since December 23, 2020PECOS EnrolledAccepts Medicare Assignment
80.99/100
CMS Quality Rating
15305 OAKLEIGH, SOUTHGATE, MI 48195(173) 428-7213 Get Directions Write a Review

NPPES record last updated: June 16, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jun 16, 2021, Dec 23, 2020 (2 updates tracked since 2020).

About Sherwin Guimalan Hisona NPPES

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

SHERWIN GUIMALAN HISONA (NPI 1235726399) is an individual nurse practitioner in Southgate, Michigan, licensed in Michigan (4704246725) and active in the NPI registry since December 2020. He is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital - Dearborn, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1235726399
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameSHERWIN GUIMALAN HISONA
Location Address15305 OAKLEIGHSouthgate, MI 48195-8532
Mailing Address15305 OakleighSouthgate, MI 48195-8532
Phone(173) 428-7213
Sole ProprietorYes
Medical School CMSOtherGraduated 2020
Enumeration DateDecember 23, 2020
Last NPPES UpdateJune 16, 20212 updates tracked since enumeration
NPPES CertifiedMay 28, 2021
✔ NPI 1235726399 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 MI · 4704246725
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.
15305 OAKLEIGH, Southgate, MI 48195
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

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

Sherwin Guimalan Hisona 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 ID2769874692
PECOS Enrollment IDI20220126001294
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 3

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.
948 services223 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.
89 services77 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
30 services29 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beaumont Hospital - Dearborn

Acute Care Hospitals · Dearborn, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230020
Location18101 Oakwood BlvdDearborn, MI 48124 · Wayne County
Emergency services Birthing friendly

Garden City Hospital

Acute Care Hospitals · Garden City, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230244
Location6245 Inkster RdGarden City, MI 48135 · Wayne County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48195 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

80.99/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality67.25
Promoting Interoperability100
Improvement Activities40
Cost59.73

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 Sherwin Hisona's NPI number?

The NPI number for Sherwin Hisona is 1235726399. It was assigned to this individual provider in the NPPES registry on December 23, 2020.

Where is Sherwin Hisona located?

Sherwin Hisona practices at 15305 Oakleigh, Southgate, MI 48195. The listed phone number is (173) 428-7213.

What is Sherwin Hisona's specialty?

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

Is Sherwin Hisona enrolled in Medicare?

Yes. Sherwin Hisona 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.

What insurance does Sherwin Hisona accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Sherwin Hisona 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.

Is Sherwin Hisona affiliated with any hospitals?

According to CMS data, Sherwin Hisona is affiliated with Beaumont Hospital - Dearborn and Garden City Hospital.

When was this NPI record last updated?

The NPPES record for Sherwin Hisona was last updated on June 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.