Individual provider Active NPI

Angelo Gutierrez

  • Family Nurse Practitioner
  • Pasadena, CA
National Provider Identifier
1063205672
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95035225 Issued in CA
Practice address
540 N Oakland Ave
Pasadena, CA 91101-1112
Phone
(615) 766-6711
NPI assigned
May 27, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95035225 CA Primary

Addresses

Primary practice location

540 N Oakland Ave
Pasadena, CA 91101-1112

Mailing address

540 N Oakland Ave
Pasadena, CA 91101-1112
Phone (615) 766-6711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250721001388 CA Practitioner - Nurse Practitioner 8729594437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. John'S Community HealthGroup PAC ID 2961482690, 151 clinicians

Practice addresses (Care Compare)

1060 W Exposition Blvd
Los Angeles, CA 90037-3632
Phone (323) 541-1600

1741 E 120TH St
Los Angeles, CA 90059-3051
Phone (323) 541-1600

2115 N Wilmington Ave
Compton, CA 90222-2030
Phone (310) 603-1332

2512 Alta St
Los Angeles, CA 90031-2457
Phone (323) 441-2139

5701 S Hoover St
Los Angeles, CA 90037-4045
Phone (323) 541-1411

808 W 58TH St
Los Angeles, CA 90037-3632
Phone (323) 541-1400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95035225CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Jul 7, 2025 Accepting new patients
St. Johns Community Health Current Accepting new patients
St. Johns Community Health CurrentSince Jul 7, 2025 Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

1821 S San Jacinto Ave
Ste D
San Jacinto, CA 92583
Phone 32328598302332

1500 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 381-1591

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1063205672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 N OAKLAND AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011112",
            "telephone_number": "615-766-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 N OAKLAND AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911011112",
            "telephone_number": "615-766-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "ANGELO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95035225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.