NPIMap

Individual provider Active NPI

Hector Manuel Gutierrez Jr., PA C

  • Physician Assistant
  • Pasco, WA
National Provider Identifier
1043256233
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003370 Issued in WA
Practice address
520 N 4TH Ave
Pasco, WA 99301-5257
Phone
(509) 547-7704
Fax
(509) 542-3032
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X PA10003370 WA
Physician Assistant 363A00000X PA10003370 WA Primary

Addresses

Primary practice location

520 N 4TH Ave
Pasco, WA 99301-5257

Mailing address

505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180

Other identifiers 5

IdentifierTypeStateIssuer
0222295OtherWALIWA
8323081MedicaidWA
3945GUOtherWABSWA
3075GUOtherWABSWA
0202688OtherWALIWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050404000311 WA Practitioner - Physician Assistant 4385691203 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Urgent Care, PLLC CurrentSince Jun 1, 2023 Accepting new patients
Lourdes Hospital LLC Current Accepting new patients
Yakima Emergency Group a Professional Limited Liability Com Emergency Medicine Past Accepting new patients
Washington Em-I Medical Services PC Emergency Medicine Past Accepting new patients
Lourdes Hospital LLC Past Accepting new patients
Columbia Valley Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Our Lady of Lourdes Hospital at Pasco Past Accepting new patients
Northwest Physician Associates, Apc Emergency Medicine Past Accepting new patients
Washington Em-I Medical Services PC Emergency Medicine Past Accepting new patients

Locations

507 N 5th Ave
Pasco, WA 99301
Phone (509) 543-1975

520 N 4th Ave
Pasco, WA 99301
Phone (509) 544-6140

5426 Road 68
Ste D
Pasco, WA 99301

7425 Wrigley Dr
Ste 204
Pasco, WA 99301
Phone (509) 416-0027

1175 Carondelet Dr
Richland, WA 99354
Phone (509) 943-9104

37 Columbia Point Dr
Richland, WA 99352
Phone (509) 300-1500

Interoperability endpoints

  • Direct secure messaging: hgutierrez@direct.lmc.md

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1043256233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 4TH AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015257",
            "telephone_number": "509-547-7704",
            "fax_number": "509-542-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "HECTOR",
        "middle_name": "MANUEL",
        "name_suffix": "Jr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "PA10003370",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0222295",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8323081",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "3945GU",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "3075GU",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0202688",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

Verify at the official NPI Registry.