Individual provider Active NPI

Roberto E Perez-Gautrin, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1114147535
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
231677 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-8098
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 231677 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

345 Camp St
Unit 104
W Yarmouth, MA 02673-2476
Phone (505) 920-4185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120905000344 NC Practitioner - Diagnostic Radiology 3476645896 Reassigns benefits to 2 organizations
I20130829000798 NM Practitioner - Diagnostic Radiology 3476645896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of Albuquerque PAGroup PAC ID 2860304482, 103 clinicians

Practice addresses (Care Compare)

1211 Winding Arbor TRL
Apt 208
Raleigh, NC 27606-3991
Phone (800) 841-4236

4411 The 25 Way NE
Suite 150
Albuquerque, NM 87109-5888
Phone (505) 332-5827

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021
  • Plains Regional Medical Center Hospital, Clovis, NM, CCN 320022
  • Lincoln County Medical Center Hospital, Ruidoso, NM, CCN 321306
  • Presbyterian Espanola Hospital Hospital, Espanola, NM, CCN 320011
  • Presbyterian Santa Fe Medical Center Hospital, Santa Fe, NM, CCN 320090

Merit-based Incentive Payment System (MIPS)

Final score
89.28 of 100Reported as group
Quality
90
Improvement activities
40
Cost
77.05

Merit-based Incentive Payment System (MIPS)

Final score
91.5 of 100Reported as group
Quality
90
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
231677MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Imaging LLC Diagnostic Radiology CurrentSince Jan 1, 2016 Accepting new patients

Locations

700 Lomas Blvd NE
Albuquerque, NM 87102
Phone (505) 242-1711

2400 Unser Blvd SE
Ste 29200
Albuquerque, NM 87124

4411 The 25 Way NE
Ste 150
Albuquerque, NM 87109
Phone (505) 332-5800

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 and National Provider Directory roles.

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1114147535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 CAMP ST",
            "address_2": "UNIT 104",
            "city": "W YARMOUTH",
            "state": "MA",
            "postal_code": "026732476",
            "telephone_number": "505-920-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-8098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-GAUTRIN",
        "first_name": "ROBERTO",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "231677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.