Individual provider Active NPI

Christopher A Gutierrez, MD

  • Emergency Medicine Physician
  • Farmington, NM
National Provider Identifier
1053419374
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD2006-0298 Issued in NM
Practice address
801 W Maple St
Farmington, NM 87401
Phone
(505) 609-2000
NPI assigned
Sep 20, 2006
Last updated
Oct 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD2006-0298 NM Primary

Addresses

Primary practice location

801 W Maple St
Farmington, NM 87401

Mailing address

PO Box 6210
Farmington, NM 87499-6210
Phone (505) 609-2258

Other practice location 1

11600 W 2nd Pl
Lakewood, CO 80228-1527
Phone (720) 321-4161

Other practice location 2

11600 W 2nd Pl
Lakewood, CO 80228-1527
Phone (720) 321-4161

Other identifiers 3

IdentifierTypeStateIssuer
72122579MedicaidCO
20326023101OtherCOPACIFICARE SECURE HORIZONS
814738MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071029000488 NM Practitioner - Emergency Medicine 9537256102 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Colorado School of Medicine, Denver, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3917 W Rd
Los Alamos, NM 87544-2275
Phone (505) 662-4201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.44 of 100Reported as group
Quality
96.88
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2006-0298NMMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc Emergency Medicine CurrentSince Oct 15, 2018 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
Los Alamos Emergency Medical Associates Inc Emergency Medicine CurrentSince Apr 23, 2015 Accepting new patients
San Juan Regional Medical Center Inc Family Medicine CurrentSince Oct 15, 2018 Accepting new patients
Jemez Mountain Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011

3917 West Rd
Los Alamos, NM 87544
Phone (505) 661-9584

Interoperability endpoints

  • Direct secure messaging: pti9617@yourcarecommunity.org

Organizations & group practices 6

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

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1053419374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6210",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874996210",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87401",
            "telephone_number": "505-609-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11600 W 2nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281527",
            "country_code": "US",
            "telephone_number": "720-321-4161",
            "fax_number": "720-321-4165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11600 W 2nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802281527",
            "country_code": "US",
            "telephone_number": "720-321-4161",
            "fax_number": "720-321-4165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2006-0298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72122579",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE SECURE HORIZONS",
            "identifier": "20326023101",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "814738",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.