NPIMap

Organization Active NPI

Clinica Medica del Sol, LLC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1023155991
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32998 Issued in AZ
Legal business name
CLINICA MEDICA DEL SOL, LLC
Practice address
8022 N 27TH Ave
Phoenix, AZ 85051-6302
Phone
(602) 513-3616
Fax
(480) 657-9265
NPI assigned
Jan 31, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Joseph M Gutierrez, M.D.NPI 1538143300
Title
Owner
Phone
(602) 513-3616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32998 AZ Primary

Addresses

Primary practice location

8022 N 27TH Ave
Phoenix, AZ 85051-6302

Mailing address

PO Box 55015
Phoenix, AZ 85078-5015
Phone (602) 513-3616

Other identifiers 1

IdentifierTypeStateIssuer
871089MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070427000187 AZ Part B Supplier - Clinic/Group Practice 7315043908 Receives reassigned benefits from 13 practitioners
Practice locations: Phoenix, AZ; Mesa, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1065193Clinica Medica del Sol LLC8022 N 27TH Avenue, Phoenix, AZ 85051Certificate of waiverFeb 22, 2027

National Provider Directory

National Provider Directory

Locations

8022 N 27th Ave
Phoenix, AZ 85051
Phone (602) 513-3616

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023155991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55015",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850785015",
            "telephone_number": "602-513-3616",
            "fax_number": "480-657-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8022 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850516302",
            "telephone_number": "602-513-3616",
            "fax_number": "480-657-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MEDICA DEL SOL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-513-3616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "32998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "871089",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.