DR. MICHAEL GUMA D.O.
NPI 1376655407
Internal Medicine - Rheumatology in Clifton, NJ

Q: What is Michael Guma's NPI number?

The NPI number for Michael Guma is 1376655407. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Q: What is Michael Guma's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Q: When was this NPI record last updated?

The NPPES record for Michael Guma was last updated on May 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.

Active since August 31, 2006PECOS EnrolledAccepts Medicare Assignment

84.01/100

CMS Quality Rating

1 METRO BLVD, CLIFTON, NJ 07014(973) 230-6610(551) 996-0202 Get Directions Write a Review

NPPES record last updated: May 26, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Dr. Michael Guma D.o. NPPES

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

DR. MICHAEL GUMA D.O. (NPI 1376655407) is an individual rheumatology provider in Clifton, New Jersey, licensed in New Jersey (25MB05563400) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Hackensack University Medical Center, and maintains a secondary practice location in North Arlington.

NPPES Registry Identity

NPI1376655407

Entity TypeIndividualMale

Primary Taxonomy207RR0500X

Provider Legal NameDR. MICHAEL GUMACredential: D.O.

Location Address1 METRO BLVDClifton, NJ 07014-0010

Mailing Address331 Newman Springs Rd Ste 220Red Bank, NJ 07701-5792 · (732) 807-0877 · Fax (201) 751-1680

Phone(973) 230-6610

Fax(551) 996-0202

Sole ProprietorNo

Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 1989

Enumeration DateAugust 31, 2006

Last NPPES UpdateMay 26, 2026

NPPES CertifiedMay 26, 2026

✔ NPI 1376655407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians

Taxonomy Code207RR0500X

License✔ Licensed in NJ · 25MB05563400

Definition

An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

1 METRO BLVD, Clifton, NJ 07014

Open in Google Maps ↗

Secondary Practice Location 1

Location 1312 Belleville Tpke, Suite 3ANorth Arlington, NJ 07031-6463 · Phone (201) 998-2800 · Fax (201) 998-0800

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware, 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

Dr. Michael Guma D.o. 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 ID5890759245

PECOS Enrollment IDI20041116000016

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

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

Optum Medical Care Of New Jersey PC

33 mi

Pediatrics

1 DAKOTA DR
New Hyde Park, NY 11042

Reassigned Medicare billing, New Jersey enrollment
417 clinicians in this Medicare group

NPI 1578665048 (516) 627-1811

Hackensack Meridian Health Medical Group - Specialty Care PC

44 mi

Surgical Critical Care

331 NEWMAN SPRINGS RD STE 220
Red Bank, NJ 07701

Reassigned Medicare billing, New Jersey enrollment
2,844 clinicians in this Medicare group

NPI 1215989249 (732) 807-0800

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 12

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.

Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) J0129

Abatacept is a medication administered via injection under a doctor's supervision. It's used to treat conditions like rheumatoid arthritis by moderating the immune system. This code applies when the doctor administers the drug, not for self-administration.

5,550 services12 patients

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

1,860 services19 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.

623 services243 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.

165 services111 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

108 services20 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

89 services37 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

69 services15 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

63 services38 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

56 services41 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.

48 services48 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

45 services24 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

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

Hackensack University Medical Center

Acute Care Hospitals · Hackensack, NJ

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310001

Location30 Prospect AveHackensack, NJ 07601 · Bergen County

Emergency services Birthing friendly

Southern Ocean Medical Center

Acute Care Hospitals · Manahawkin, NJ

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310113

Location1140 Rt 72 WManahawkin, NJ 08050 · Ocean County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07014 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

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.

84.01/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

68.67

Promoting Interoperability

Improvement Activities

Cost

76.48

Other Providers at the Same Location NPPES 8

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

DR. ALEXA BETH STEUER MD, MPH

Dermatology (MOHS-Micrographic Surgery)

1 METRO BLVD, STE 3C
CLIFTON, NJ 07014

Passaic County (973) 230-6643

JAMES HENNIG R.PH.

Pharmacist

1 METRO BLVD
CLIFTON, NJ 07014

Passaic County (973) 230-6620

HACKENSACK MERIDIAN AMBULATORY CARE, INC

Pharmacy (Community/Retail Pharmacy)

1 METRO BLVD
CLIFTON, NJ 07014

Passaic County (973) 830-7905

SHENELLE K GOODEN APN

Nurse Practitioner (Family)

1 METRO BLVD, STE 2D
CLIFTON, NJ 07014

Passaic County (973) 230-6666

GIAN DEV PAL M.D.

Psychiatry & Neurology (Neurology)

1 METRO BLVD, STE 3B
CLIFTON, NJ 07014

Passaic County (732) 321-7010

DR. CHRISTOPHER RAYMOND KOLLER MD

Urology

1 METRO BLVD
CLIFTON, NJ 07014

Passaic County (973) 230-6666

DR. EPHREM ODOY OLWENY M.D.

Urology

1 METRO BLVD
CLIFTON, NJ 07014

Passaic County (973) 230-6666

MOMINA FATHIMA RAHMAN M.D.

Family Medicine

1 METRO BLVD, SUITE 2A
CLIFTON, NJ 07014

Passaic County (973) 230-6610

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 Michael Guma's NPI number?

The NPI number for Michael Guma is 1376655407. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Where is Michael Guma located?

Michael Guma practices at 1 Metro Blvd, Clifton, NJ 07014. The listed phone number is (973) 230-6610.

What is Michael Guma's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Michael Guma enrolled in Medicare?

Yes. Michael Guma 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 Michael Guma's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Guma reassigns Medicare benefits to 2 organizations: Optum Medical Care Of New Jersey PC (New Hyde Park, NY) and Hackensack Meridian Health Medical Group - Specialty Care PC (Red Bank, 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 Michael Guma's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Guma accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Oscar Health list Michael Guma 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 Michael Guma affiliated with any hospitals?

According to CMS data, Michael Guma is affiliated with Hackensack University Medical Center and Southern Ocean Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Guma was last updated on May 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.