Individual provider Active NPI

Olinda Christine Gutierrez, P.A.-C

  • Physician Assistant
  • Boerne, TX
National Provider Identifier
1124152624
Registry record updated Aug 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04074 Issued in TX
Practice address
1510 S Main St
Boerne, TX 78006-3308
Phone
(830) 816-4357
Fax
(830) 333-1871
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04074 TX Primary

Addresses

Primary practice location

1510 S Main St
Boerne, TX 78006-3308

Mailing address

1510 S Main St
Boerne, TX 78006-3308
Phone (830) 816-4357

Other practice location 1

212 US Hwy 87
Comfort, TX 78013-3705
Phone (830) 995-3887

Other names 1

  • Lindi Christine Gutierrez Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140829001751 TX Practitioner - Physician Assistant 4880812064 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Golabs Cbandj Relief PLLCGroup PAC ID 8628423571, 4 clinicians

Practice addresses (Care Compare)

1205 N Loop 1604
Suite 211
San Antonio, TX 78258-4627
Phone (210) 764-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Heart Care of San Antonio Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFCJBD/Endpoint/AFCJBD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566604800000",
    "number": "1124152624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 S MAIN ST",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063308",
            "telephone_number": "830-816-4357",
            "fax_number": "830-331-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S MAIN ST",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063308",
            "telephone_number": "830-816-4357",
            "fax_number": "830-333-1871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 US Hwy 87",
            "address_purpose": "LOCATION",
            "city": "Comfort",
            "state": "TX",
            "postal_code": "780133705",
            "country_code": "US",
            "telephone_number": "830-995-3887",
            "fax_number": "830-995-3393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "OLINDA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2019-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDI",
            "last_name": "GUTIERREZ",
            "middle_name": "CHRISTINE",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.