RAFAEL GUZMAN MD
NPI 1750730016
Family Medicine in Utica, NY

Q: What is Rafael Guzman's NPI number?

The NPI number for Rafael Guzman is 1750730016. It was assigned to this individual provider in the NPPES registry on June 8, 2016.

Q: What is Rafael Guzman's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Rafael Guzman was last updated on June 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since June 08, 2016PECOS EnrolledAccepts Medicare Assignment

1656 CHAMPLIN AVE, UTICA, NY 13502(315) 624-6829 Get Directions Write a Review

NPPES record last updated: June 9, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 9, 2022, Apr 22, 2021 (2 updates tracked since 2021).

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About Rafael Guzman Md NPPES

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

RAFAEL GUZMAN MD (NPI 1750730016) is an individual family medicine provider in Utica, New York, licensed in New York (299929) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with Wynn Hospital, and is a graduate of Other (1991).

NPPES Registry Identity

NPI1750730016

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameRAFAEL GUZMANCredential: MD

Location Address1656 CHAMPLIN AVEUtica, NY 13502-4830

Mailing Address2209 Genesee St, Business Office Room 315Utica, NY 13501-1807 · (315) 801-8534 · Fax (315) 801-8391

Phone(315) 624-6829

Sole ProprietorNo

Medical School CMSOtherGraduated 1991

Enumeration DateJune 8, 2016

Last NPPES UpdateJune 9, 20222 updates tracked since enumeration

NPPES CertifiedJune 2, 2022

✔ NPI 1750730016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in NY · 299929✔ Licensed in NM · 299929

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1656 CHAMPLIN AVE, Utica, NY 13502

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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

Rafael Guzman Md 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 ID244568038

PECOS Enrollment IDI20190816002444

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 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.

430 services153 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

365 services132 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.

187 services184 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

104 services38 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.

41 services41 patients

Hospital Affiliations CMS Care Compare

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

Wynn Hospital

Acute Care Hospitals · Utica, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330044

Location111 Hospital DriveUtica, NY 13502 · Oneida County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13502 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers18 claims18 services$12.80 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers27 claims27 services$60.51 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.

DR. JOHN F SPERLING M.D.

Surgery

1656 CHAMPLIN AVE, P.O.B., SUITE 335
UTICA, NY 13502

Oneida County (315) 624-4090

MR. TRACY S HEATON R.PH,

Pharmacist