Rafael Guillen, M.D.
NPI 1861430076 · Internal Medicine Physician · Bronx, NY
Enrolled with Medicare as Practitioner - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Rafael Guillen, M.D. is a Internal Medicine Physician provider in Bronx, NY (NPI 1861430076).
Provider details
- NPI number
- 1861430076
- Entity type
- Individual
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 233234 (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
20 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
123 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) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 75 | $112 |
| Annual Wellness Visit, Includes a Personalized Prevention Plan of Service (pps), Subsequent VisitG0439 | 26 | $146 |
| Routine Electrocardiogram (ecg) Using at Least 12 Leads With Interpretation and Report Only93010 | 22 | $9 |
Typical Medicare-allowed amounts for these services range $9–$146 (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 · 169 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Atorvastatin Calcium | 887 | 312 |
| Amlodipine Besylate | 676 | 215 |
| Alendronate Sodium | 570 | 208 |
| Omeprazole | 505 | 170 |
| Hydrochlorothiazide | 503 | 163 |
| Losartan Potassium | 416 | 136 |
| Metformin Hcl | 394 |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$527 across 24 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
- 2006-06-02
- Last updated
- 2020-05-28
- Certified
- 2020-05-28
Frequently asked questions
- What is Rafael Guillen's NPI number?
- Rafael Guillen's National Provider Identifier (NPI) is 1861430076, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Rafael Guillen's specialty?
- Rafael Guillen is listed in the NPPES registry with a primary specialty of Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Rafael Guillen located?
- Rafael Guillen's practice location on file with NPPES is 800 Grand Concourse Frnt Office5, Bronx, NY 10451-3003.
- What is Rafael Guillen's phone number?
- The practice phone number listed in the NPPES registry for Rafael Guillen is (718) 401-2300.
- Does Rafael Guillen accept Medicare?
- Rafael Guillen is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Rafael Guillen's NPI active?
- Yes — Rafael Guillen's NPI (1861430076) is active in the NPPES registry as of the last update on 2020-05-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.