Individual provider Active NPI

Mitchell Gutierrez

  • Registered Nurse
  • Austin, TX
National Provider Identifier
1023567666
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
783491 Issued in TX
Practice address
5920 W William Cannon Dr Ste 150
Austin, TX 78749-1902
Phone
(512) 441-9799
NPI assigned
Sep 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 783491 TX Primary

Addresses

Primary practice location

5920 W William Cannon Dr Ste 150
Austin, TX 78749-1902

Mailing address

5920 W William Cannon Dr Ste 150
Austin, TX 78749-1902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170223000236 TX Practitioner - Nurse Practitioner 8325322159 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cogent Healthcare of Texas PAGroup PAC ID 8628076924, 113 clinicians

Practice addresses (Care Compare)

12221 N Mopac Expy
St. David'S North Austin Medical Ce
Austin, TX 78758-2401
Phone (512) 901-1000

Hospital & facility affiliations

  • Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
783491TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Critical Care Medicine Services of Texas, PLLC CurrentSince Apr 12, 2025 Accepting new patients
Cogent Healthcare of Texas, PA CurrentSince Jun 1, 2020 Accepting new patients

Locations

3801 N Lamar Blvd
Austin, TX 78756
Phone (512) 407-7000

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1023567666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 W WILLIAM CANNON DR STE 150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 W WILLIAM CANNON DR STE 150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491902",
            "telephone_number": "512-441-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MITCHELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "783491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.