Individual provider Active NPI

Elvira J Gutierrez, PA

  • Physician Assistant
  • Linden, NJ
National Provider Identifier
1174613178
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00139500 Issued in NJ
Practice address
328 W Saint Georges Ave
Linden, NJ 07036-5638
Phone
(908) 925-2273
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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 25MP00139500 NJ Primary

Addresses

Primary practice location

328 W Saint Georges Ave
Linden, NJ 07036-5638

Mailing address

110 Bender Ave
Roselle Park, NJ 07204-2402

Other practice location 1

111 Central Avenue
Saint Michael's Medical Center
Newark, NJ 07102
Phone (973) 877-5320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20051221000181 NJ Practitioner - Physician Assistant 3678595451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert Wood Johnson Medical Associates at Hamilton PAGroup PAC ID 6204805419, 45 clinicians

Practice addresses (Care Compare)

328 W Saint Georges Ave
Linden, NJ 07036-5638

90 Route 22
Springfield, NJ 07081-3110
Phone (973) 467-2273

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Wood Johnson Medical Associates at Hamilton PA CurrentSince Apr 20, 2024 Accepting new patients

Locations

328 W Saint Georges Ave
Linden, NJ 07036
Phone (608) 925-2273

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1174613178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BENDER AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 W SAINT GEORGES AVE",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070365638",
            "telephone_number": "908-925-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Central Avenue",
            "address_2": "Saint Michael's Medical Center",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "07102",
            "country_code": "US",
            "telephone_number": "973-877-5320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "ELVIRA",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00139500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linden, NJ

Sources for this page

Verify at the official NPI Registry.