NPIMap

Individual provider Active NPI

Omar Alberto Colon Gutierrez, MD

  • Physical Medicine & Rehabilitation Physician
  • Plano, TX
National Provider Identifier
1063413482
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
L3943 Issued in TX
Practice address
2800 W 15TH St
Plano, TX 75075-7526
Phone
(972) 378-6908
Fax
(972) 378-6586
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X L3943 TX
Physical Medicine & Rehabilitation Physician 208100000X L3943 TX Primary

Addresses

Primary practice location

2800 W 15TH St
Plano, TX 75075-7526

Mailing address

7750 North Macarthur
Suite 120 338
Irving, TX 75063-7514
Phone (972) 378-6908

Other identifiers 2

IdentifierTypeStateIssuer
L3943OtherTXLICENSE NUMBER
8V3207OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040803000084 TX Practitioner - Physical Medicine and Rehabilitation 1850362070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Texas Southwestern Medical School at Dallas, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuromusculoskeletal Rehabilitation Medicine ConsultantGroup PAC ID 2365457306, 4 clinicians

Practice addresses (Care Compare)

3600 Mapleshade LN
Plano, TX 75075-5715
Phone 8172849850121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
95
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L3943TXMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neuromusculoskeletal Rehabilitation Medicine Consultant Physical Medicine & Rehabilitation CurrentSince Mar 1, 2006 Accepting new patients
Reunion Rehabilitation Hospital Plano, LLC Past Accepting new patients
Quality Physical Medicine & Rehabilitation PA Physical Medicine & Rehabilitation Past Accepting new patients

Locations

2601 W Randol Mill Rd
Ste 101
Arlington, TX 76012
Phone (469) 893-0123

4343 N Josey Ln
Ste 3
Carrollton, TX 75010
Phone (972) 890-1541

7750 N MacArthur Blvd
Irving, TX 75063
Phone (972) 401-0008

7750 N MacArthur Blvd
#120338
Irving, TX 75063

7750 N MacArthur Blvd
Ste 120
Irving, TX 75063
Phone (216) 825-5879

1802 Highway 157 N
Mansfield, TX 76063
Phone (817) 473-6101

2800 W 15th St
Plano, TX 75075
Phone (972) 238-7339

Organizations & group practices 3

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 6

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1063413482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 NORTH MACARTHUR",
            "address_2": "SUITE 120 338",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750637514",
            "telephone_number": "972-378-6908",
            "fax_number": "972-378-6586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W 15TH ST",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757526",
            "telephone_number": "972-378-6908",
            "fax_number": "972-378-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON GUTIERREZ",
        "first_name": "OMAR",
        "middle_name": "ALBERTO",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "TX",
            "license": "L3943",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "L3943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "L3943",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8V3207",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.