Individual provider Active NPI

Gregory James Jutzy, M.D.

  • Pediatric Cardiology Physician
  • Loma Linda, CA
National Provider Identifier
1184917353
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
A122156 Issued in CA
Practice address
11234 Anderson St
Loma Linda, CA 92354-2804
Phone
(909) 651-5369
NPI assigned
May 20, 2011
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A122156 CA
Pediatric Cardiology Physician 2080P0202X A122156 CA Primary

Addresses

Primary practice location

11234 Anderson St
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson St # Mc4437
Loma Linda, CA 92354-2804
Phone (909) 651-5369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140710000578 CA Practitioner - Pediatric Medicine 5092930818 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Loma Linda University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A122156CAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics CurrentSince Aug 1, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System CurrentSince Jul 1, 2019 Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Sac Health System CurrentSince Jul 1, 2019 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
#4437
Loma Linda, CA 92350

11234 Anderson St
Ofc Csp
Loma Linda, CA 92350
Phone (909) 558-4015

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

11401 Heacock St
Ste 330
Moreno Valley, CA 92557
Phone (951) 247-8697

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Interoperability endpoints

  • Direct secure messaging: gjutzy8157@direct.llu.edu

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1305849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1184917353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # MC4437",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-651-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-651-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUTZY",
        "first_name": "GREGORY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-20",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A122156",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A122156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.