Individual provider Active NPI

Carlos Gutierrez, CRNA

  • Certified Registered Nurse Anesthetist
  • Baltimore, MD
National Provider Identifier
1063083855
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1149842 Issued in TX
Practice address
525 N Wolfe St
Baltimore, MD 21205-2110
Phone
(410) 955-4766
NPI assigned
Jul 2, 2021
Last updated
Jan 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1149842 TX Primary
Critical Care Medicine Registered Nurse 163WC0200X 861659 TX

Addresses

Primary practice location

525 N Wolfe St
Baltimore, MD 21205-2110

Mailing address

525 N Wolfe St
Baltimore, MD 21205-2110

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240228000709 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517302748 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Ams PLLCGroup PAC ID 9133441769, 143 clinicians
El Paso Ams PLLCGroup PAC ID 9931520970, 87 clinicians

Practice addresses (Care Compare)

1801 N Oregon St
El Paso, TX 79902-3524
Phone (915) 595-9000

2000 Transmountain Rd
El Paso, TX 79911-3601
Phone (915) 577-8467

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
861659TXMDCritical Care Medicine Registered Nurse
1149842TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso Ams, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2024 Accepting new patients

Locations

1801 N Oregon St
El Paso, TX 79902
Phone (409) 883-9361

2000 Transmountain Rd
El Paso, TX 79911
Phone (915) 247-8893

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, 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": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1063083855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052110",
            "telephone_number": "410-955-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "CARLOS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-02",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1149842",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "861659",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.