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MS. MARGRET DE JESUS DE GUZMAN M.D.
NPI 1477852028
Surgery in Red Bud, IL

Active since March 22, 2011PECOS EnrolledAccepts Medicare Assignment
95.01/100
CMS Quality Rating
RED BUD ILLINOIS HOSPITAL COMANY LLC, 325 SPRING ST, RED BUD, IL 62278(618) 282-7373(618) 282-7376 Get Directions Write a Review

NPPES record last updated: May 29, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 29, 2026, Feb 25, 2021, May 24, 2019 and 2 more (5 updates tracked since 2017).

About Ms. Margret De Jesus De Guzman M.d. NPPES

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

MS. MARGRET DE JESUS DE GUZMAN M.D. (NPI 1477852028) is an individual surgery provider in Red Bud, Illinois, licensed in North Carolina (2018-02941) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1477852028
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameMS. MARGRET DE JESUS DE GUZMANCredential: M.D.
Location AddressRED BUD ILLINOIS HOSPITAL COMANY LLC, 325 SPRING STRed Bud, IL 62278
Mailing Address325 Spring StRed Bud, IL 62278-1105 · (618) 282-7373 · Fax (618) 282-7376
Phone(618) 282-7373
Fax(618) 282-7376
Sole ProprietorYes
Medical School CMSUniversity Of South Florida College Of MedicineGraduated 2011
Enumeration DateMarch 22, 2011
Last NPPES UpdateMay 29, 20265 updates tracked since enumeration
NPPES CertifiedMay 29, 2026
✔ NPI 1477852028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in NC · 2018-02941✔ Licensed in IL · 036.148607
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
RED BUD ILLINOIS HOSPITAL COMANY LLC, Red Bud, IL 62278
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Secondary Practice Locations 2

Location 11300 N Market StSparta, IL 62286-1048 · Phone (618) 443-4138 · Fax (618) 443-3327
Location 2818 E Broadway StSparta, IL 62286-1820 · Phone (618) 443-1337 · Fax (618) 443-1383

Accepted Insurance

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

Ms. Margret De Jesus De Guzman 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 ID6103047543
PECOS Enrollment IDI20190510000846
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

4

Medicare enrollment records show Margret De Guzman reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Deaconess Illinois Red Bud Regional Hospital Inc
0.6 mi
Rural Health
325 SPRING ST
Red Bud, IL 62278
  • Reassigned Medicare billing, Illinois enrollment
  • 22 clinicians in this Medicare group
NPI 1619693926 (618) 282-7373
Sparta Community Hospital
17 mi
Critical Access
818 E BROADWAY ST
Sparta, IL 62286
  • Reassigned Medicare billing, Illinois enrollment
  • 23 clinicians in this Medicare group
NPI 1548216476 (618) 443-2177
Sparta Community Hospital D/B/A Quality Healthcare Clinics
17 mi
Multi-Specialty
818 E. BROADWAY STREET
Sparta, IL 62286
  • Reassigned Medicare billing, Illinois enrollment
  • 51 clinicians in this Medicare group
NPI 1114984226 (618) 443-1337
Memorial Hospital
22 mi
Critical Access
1900 STATE ST
Chester, IL 62233
  • Reassigned Medicare billing, Illinois enrollment
  • 62 clinicians in this Medicare group
NPI 1851390132 (618) 826-4581

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

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.

Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Memorial Hospital

Critical Access Hospitals · Chester, IL
OwnershipGovernment - Hospital District or Authority
CMS Certification Number141338
Location1900 State StChester, IL 62233 · Randolph County
Emergency services

Red Bud Regional Hospital

Critical Access Hospitals · Red Bud, IL
OwnershipProprietary
CMS Certification Number141348
Location325 Spring StreetRed Bud, IL 62278 · Randolph County
Emergency services

Sparta Community Hospital

Critical Access Hospitals · Sparta, IL
OwnershipGovernment - Hospital District or Authority
CMS Certification Number141349
Location818 E BroadwaySparta, IL 62286 · Randolph County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62278 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
$88.44 typical visit price
range $56.28 – $173.35
Typical copayment $22.11 (range $14.07 – $43.33)
Most-billed visit code 99203
Established Patient
$70.42 typical visit price
range $17.51 – $139.99
Typical copayment $17.60 (range $4.37 – $34.99)
Most-billed visit code 99213
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.

95.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.02
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Provide Patients Electronic Access to Their Health Information
63%32 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Margret De Guzman's NPI number?

The NPI number for Margret De Guzman is 1477852028. It was assigned to this individual provider in the NPPES registry on March 22, 2011.

Where is Margret De Guzman located?

Margret De Guzman practices at Red Bud Illinois Hospital Comany LLC 325 Spring St, Red Bud, IL 62278. The listed phone number is (618) 282-7373.

What is Margret De Guzman's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Margret De Guzman enrolled in Medicare?

Yes. Margret De Guzman 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 Margret De Guzman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Margret De Guzman reassigns Medicare benefits to 4 organizations: Deaconess Illinois Red Bud Regional Hospital Inc (Red Bud, IL), Sparta Community Hospital (Sparta, IL), Sparta Community Hospital D/B/A Quality Healthcare Clinics (Sparta, IL) and Memorial Hospital (Chester, IL). 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 Margret De Guzman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Margret De Guzman accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Margret De Guzman 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 Margret De Guzman affiliated with any hospitals?

According to CMS data, Margret De Guzman is affiliated with Memorial Hospital, Red Bud Regional Hospital and Sparta Community Hospital.

When was this NPI record last updated?

The NPPES record for Margret De Guzman was last updated on May 29, 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.