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JUSTIN GUZMAN
NPI 1912230954
Physician Assistant in Appleton, WI

Active since September 09, 2009PECOS EnrolledAccepts Medicare Assignment
2500 E CAPITOL DR STE 2500, APPLETON, WI 54911(920) 831-5050(920) 738-6400 Get Directions Write a Review

NPPES record last updated: March 29, 2018. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 29, 2018, Feb 25, 2016 (2 updates tracked since 2016).

About Justin Guzman NPPES

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

JUSTIN GUZMAN (NPI 1912230954) is an individual physician assistant in Appleton, Wisconsin, licensed in Wisconsin (3725 - 23) and active in the NPI registry since September 2009. He is enrolled in Medicare PECOS, is affiliated with Thedacare Regional Med Ctr - Neenah, and maintains a secondary practice location in Appleton.

NPPES Registry Identity

NPI1912230954
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJUSTIN GUZMAN
Location Address2500 E CAPITOL DR STE 2500Appleton, WI 54911-8735
Mailing Address2105 E Enterprise AveAppleton, WI 54913-7862 · (920) 731-3111
Phone(920) 831-5050
Fax(920) 738-6400
Sole ProprietorNo
Medical School CMSYale University School Of MedicineGraduated 2015
Enumeration DateSeptember 9, 2009
Last NPPES UpdateMarch 29, 20182 updates tracked since enumeration
✔ NPI 1912230954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in WI · 3725 - 23
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2500 E CAPITOL DR STE 2500, Appleton, WI 54911
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Secondary Practice Location 1

Location 12105 E Enterprise AveAppleton, WI 54913-7862 · Phone (920) 731-3111

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) 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

Justin Guzman 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 ID7416255252
PECOS Enrollment IDI20160412001928
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 8

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.
164 services138 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.
111 services70 patients
Injection, methylprednisolone acetate, 80 mg J1040
Methylprednisolone acetate is a strong anti-inflammatory medication. It is often given as an 80 mg injection to reduce inflammation and pain. It's commonly used for conditions like arthritis, allergic disorders, or other inflammatory diseases.
42 services29 patients
X-ray of knee, 4 or more views 73564
An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.
28 services28 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.
25 services25 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
19 services19 patients

Hospital Affiliations CMS Care Compare 2

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

Thedacare Regional Med Ctr - Neenah

Acute Care Hospitals · Neenah, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520045
Location130 2nd StNeenah, WI 54956 · Winnebago County
Emergency services Birthing friendly

Thedacare Regional Medical Center - Appleton Inc

Acute Care Hospitals · Appleton, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520160
Location1818 N Meade StAppleton, WI 54911 · Outagamie County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54911 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

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 Justin Guzman's NPI number?

The NPI number for Justin Guzman is 1912230954. It was assigned to this individual provider in the NPPES registry on September 9, 2009.

Where is Justin Guzman located?

Justin Guzman practices at 2500 E Capitol Dr Ste 2500, Appleton, WI 54911. The listed phone number is (920) 831-5050.

What is Justin Guzman's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Justin Guzman enrolled in Medicare?

Yes. Justin 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.

What insurance does Justin Guzman accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 2 other insurers list Justin 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 Justin Guzman affiliated with any hospitals?

According to CMS data, Justin Guzman is affiliated with Thedacare Regional Med Ctr - Neenah and Thedacare Regional Medical Center - Appleton Inc.

When was this NPI record last updated?

The NPPES record for Justin Guzman was last updated on March 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.