Carl Guillaume, M.D.
NPI 1528098118 · Gastroenterology Physician · Bronx, NY
Enrolled with Medicare as Practitioner - Gastroenterology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Carl Guillaume, M.D. is a Gastroenterology Physician provider in Bronx, NY (NPI 1528098118).
Provider details
- NPI number
- 1528098118
- Entity type
- Individual
- Primary specialty
- Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 210261 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
19 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
78 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Initial Nursing Facility Care With Moderate Level of Medical Decision Making, Per Day, If Using Time, at Least 35 Minutes99305 | 38 | $146 |
| Subsequent Nursing Facility Care With Straightforward Level of Medical Decision Making, Per Day, If Using Time, 20 Minutes Or More99308 | 28 | $82 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 12 | $188 |
Typical Medicare-allowed amounts for these services range $82–$188 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 8 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Famotidine | 327 | 110 |
| Omeprazole | 220 | 81 |
| Linaclotidebrand: Linzess | 216 | 62 |
| Pantoprazole Sodium | 36 | 12 |
| Hydrocortisonebrand: Proctozone-Hc | 24 | — |
| Hydrocortisonebrand: Procto-Med Hc | 19 | — |
| Ondansetron Hcl | 15 | — |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$94 across 4 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-07-03
- Last updated
- 2007-07-08
Frequently asked questions
- What is Carl Guillaume's NPI number?
- Carl Guillaume's National Provider Identifier (NPI) is 1528098118, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Carl Guillaume's specialty?
- Carl Guillaume is listed in the NPPES registry with a primary specialty of Gastroenterology Physician (Allopathic & Osteopathic Physicians).
- Where is Carl Guillaume located?
- Carl Guillaume's practice location on file with NPPES is 4422 3rd Ave, Bronx, NY 10457-2545.
- What is Carl Guillaume's phone number?
- The practice phone number listed in the NPPES registry for Carl Guillaume is (718) 960-6205.
- Does Carl Guillaume accept Medicare?
- Carl Guillaume is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Carl Guillaume's NPI active?
- Yes — Carl Guillaume's NPI (1528098118) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.