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DR. RAFAEL A. GUILLEN M.D.
NPI 1861430076
Internal Medicine in Bronx, NY

Active since June 02, 2006PECOS EnrolledAccepts Medicare Assignment
800 GRAND CONCOURSE FRNT OFFICE5, BRONX, NY 10451(718) 401-2300(718) 401-2322 Get Directions Write a Review

NPPES record last updated: May 28, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Rafael A. Guillen M.d. NPPES

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

DR. RAFAEL A. GUILLEN M.D. (NPI 1861430076) is an individual internal medicine provider in Bronx, New York, licensed in New York (233234) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Mount Sinai Hospital, and is a graduate of Other (1987).

NPPES Registry Identity

NPI1861430076
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. RAFAEL A. GUILLENCredential: M.D.
Location Address800 GRAND CONCOURSE FRNT OFFICE5Bronx, NY 10451-3003
Mailing Address800 Grand Concourse Frnt Office5Bronx, NY 10451-3003 · (718) 401-2300 · Fax (718) 401-2322
Phone(718) 401-2300
Fax(718) 401-2322
Sole ProprietorYes
Medical School CMSOtherGraduated 1987
Enumeration DateJune 2, 2006
Last NPPES UpdateMay 28, 2020
NPPES CertifiedMay 28, 2020
✔ NPI 1861430076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 233234
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
800 GRAND CONCOURSE FRNT OFFICE5, Bronx, NY 10451
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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. Rafael A. Guillen 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 ID6901851807
PECOS Enrollment IDI20050314000683
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

2

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

R Guillen MD PC
Same address
Primary Care
800 GRAND CONCOURSE FRNT OFFICE5
Bronx, NY 10451
  • Reassigned Medicare billing, New York enrollment
NPI 1467612499 (718) 401-2300
North Shore Medical Group Of The Mount Sinai School Of Medicine
24 mi
Internal Medicine
2020 WANTAGH AVE
Wantagh, NY 11793
  • Reassigned Medicare billing, New York enrollment
  • 572 clinicians in this Medicare group
NPI 1992417323 (516) 961-4545

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 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.

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.
75 services50 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
26 services26 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
22 services20 patients

Hospital Affiliations CMS Care Compare

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

Mount Sinai Hospital

Acute Care Hospitals · New York, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330024
LocationOne Gustave L Levy PlaceNew York, NY 10029 · New York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10451 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
$154.28 typical visit price
range $67.40 – $203.53
Typical copayment $38.57 (range $16.85 – $50.88)
Most-billed visit code 99204
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
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

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

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier11 claims11 services$198.83 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

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

R GUILLEN MD PC
Clinic/Center (Primary Care)
800 GRAND CONCOURSE FRNT OFFICE5
BRONX, NY 10451
Bronx County (718) 401-2300

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 Guillen's NPI number?

The NPI number for Rafael Guillen is 1861430076. It was assigned to this individual provider in the NPPES registry on June 2, 2006.

Where is Rafael Guillen located?

Rafael Guillen practices at 800 Grand Concourse Frnt Office5, Bronx, NY 10451. The listed phone number is (718) 401-2300.

What is Rafael Guillen's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Rafael Guillen enrolled in Medicare?

Yes. Rafael Guillen 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 Guillen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rafael Guillen reassigns Medicare benefits to 2 organizations: R Guillen MD PC (Bronx, NY) and North Shore Medical Group Of The Mount Sinai School Of Medicine (Wantagh, NY). 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 Guillen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Rafael Guillen affiliated with any hospitals?

According to CMS data, Rafael Guillen is affiliated with Mount Sinai Hospital.

When was this NPI record last updated?

The NPPES record for Rafael Guillen was last updated on May 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.