Individual provider Active NPI

Moises Gutierrez

  • Gerontology Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1083259147
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP143936 Issued in TX
Practice address
6200 N la Cholla Blvd
Tucson, AZ 85741-3529
Phone
(520) 742-9000
NPI assigned
Nov 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 323041 AZ
Gerontology Nurse Practitioner 363LG0600X AP143936 TX Primary

Addresses

Primary practice location

6200 N la Cholla Blvd
Tucson, AZ 85741-3529

Mailing address

2000B Trans Mountain Rd Ste 270
El Paso, TX 79911-3600
Phone (915) 213-0900

Other practice location 1

2000B Trans Mountain Rd Ste 270
El Paso, TX 79911-3600
Phone (915) 213-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200115001995 TX Practitioner - Nurse Practitioner 1456786706 Reassigns benefits to 4 organizations
I20250912003258 AZ Practitioner - Nurse Practitioner 1456786706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians
Northwest HBP Medical Services LLCGroup PAC ID 8921356536, 278 clinicians

Practice addresses (Care Compare)

10301 Gateway Blvd W
El Paso, TX 79925-7701
Phone (915) 263-5223

201 Seton Pkwy
Round Rock, TX 78665-8000
Phone (512) 324-4000

6001 Kyle Pkwy
Kyle, TX 78640-6112
Phone (512) 504-5000

6200 N la Cholla Blvd
Tucson, AZ 85741-3529
Phone (520) 229-2657

Hospital & facility affiliations

  • Ascension Seton Williamson Hospital, Round Rock, TX, CCN 670041
  • Northwest Medical Center Hospital, Tucson, AZ, CCN 030085
  • Las Palmas Medical Center a Campus of LPDS Healthc Hospital, El Paso, TX, CCN 450107

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
91.43

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest HBP Medical Services LLC CurrentSince Aug 16, 2025 Accepting new patients
Seton Family of Doctors CurrentSince Jun 30, 2025 Accepting new patients
Fahad Omar MD PA CurrentSince Jul 1, 2025 Accepting new patients
Revive Global PLLC CurrentSince May 1, 2025 Accepting new patients
Seton Family of Doctors CurrentSince Jun 30, 2025 Accepting new patients
Asad Omar MD PA CurrentSince Nov 6, 2019 Accepting new patients

Locations

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

5539 N Mesa St
El Paso, TX 79912

10301 Gateway Blvd W
El Paso, TX 79925
Phone (915) 543-2424

1512 N Zaragoza Rd
Ste B
El Paso, TX 79936
Phone (915) 249-3900

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1083259147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000B TRANS MOUNTAIN RD STE 270",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799113600",
            "telephone_number": "915-213-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 N LA CHOLLA BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413529",
            "telephone_number": "520-742-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000B Trans Mountain Rd Ste 270",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799113600",
            "country_code": "US",
            "telephone_number": "915-213-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MOISES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-13",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "323041",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP143936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.