Individual provider Active NPI

Lorenzo Miguel Santos Gutierrez, MD

  • Psychiatry Physician
  • Silver Spring, MD
National Provider Identifier
1134423320
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0080708 Issued in MD
Practice address
12201 Plum Orchard Dr
Silver Spring, MD 20904
Phone
(301) 579-1000
Fax
(301) 579-1005
NPI assigned
Jan 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD043741 DC
Psychiatry Physician 2084P0800X 0101259626 VA
Psychiatry Physician 2084P0800X 269288 NY
Psychiatry Physician 2084P0800X D0080708 MD Primary

Addresses

Primary practice location

12201 Plum Orchard Dr
Silver Spring, MD 20904

Mailing address

12201 Plum Orchard Dr
Silver Spring, MD 20904-7803
Phone (301) 579-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DC, VA, MD4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20131004000565 NY Practitioner - Psychiatry 5496989477 Reassigns benefits to 2 organizations
I20160311001845 DC Practitioner - Psychiatry 5496989477 Reassigns benefits to 3 organizations
I20231010002120 VA Practitioner - Psychiatry 5496989477 Reassigns benefits to 1 organization
I20260330000477 MD Practitioner - Psychiatry 5496989477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

150 Riverside Pkwy
Fredericksburg, VA 22406-1094
Phone (833) 351-8255

1775 I St NW
Suite 1150 Talkiatry
Washington, DC 20006-2435
Phone (833) 351-8255

66 E Main St
Westminster, MD 21157-5008
Phone (833) 351-8255

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
269688NYMDLicensed Practical Nurse
D0080708MDMDPsychiatry Physician
269288NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCCD Psychiatry Services PLLC Psychiatry CurrentSince Jan 1, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 16, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Feb 16, 2016 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Jan 1, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc Psychiatry Current Accepting new patients
Downtown Bronx Medical Associates PC CurrentSince Nov 7, 2013 Accepting new patients

Locations

1775 I St NW
Ste 1150
Washington, DC 20006
Phone (202) 313-7696

1500 K St NW
Fl 2
Washington, DC 20005
Phone (212) 287-4257

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

66 E Main St
Westminster, MD 21157
Phone (240) 602-3854

234 Eugenio Maria de Hosto Blvd
Bronx, NY 10451
Phone (718) 579-5874

109 W 27th St
#55
New York, NY 10001

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

2800 Eisenhower Ave
Ste 220
Alexandria, VA 22314
Phone (540) 358-0423

150 Riverside Pkwy
Ste 115
Fredericksburg, VA 22406
Phone (540) 530-5545

Organizations & group practices 6

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": "1293926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1134423320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 PLUM ORCHARD DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209047803",
            "telephone_number": "301-579-1000",
            "fax_number": "301-579-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 PLUM ORCHARD DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "20904",
            "telephone_number": "301-579-1000",
            "fax_number": "301-579-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS GUTIERREZ",
        "first_name": "LORENZO",
        "middle_name": "MIGUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-02",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DC",
            "license": "MD043741",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101259626",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "269288",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0080708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.