Individual provider Active NPI

Juan Carlos Gutierrez, M.D.

  • Surgery Physician
  • Ocala, FL
National Provider Identifier
1194978932
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME111240 Issued in FL
Practice address
1720 SE 16TH Ave Ste 303
Ocala, FL 34471-4620
Phone
(352) 368-1661
Fax
(352) 867-9497
NPI assigned
Oct 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ME111240 FL Primary

Addresses

Primary practice location

1720 SE 16TH Ave Ste 303
Ocala, FL 34471-4620

Mailing address

1720 SE 16TH Ave Ste 303
Ocala, FL 34471-4620
Phone (352) 368-1661

Other identifiers 1

IdentifierTypeStateIssuer
004133900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 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
I20120105000935 FL Practitioner - General SurgeryPractitioner - Internal Medicine 0749456101 Reassigns benefits to 1 organization
I20140210000159 TX Practitioner - General Surgery 0749456101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Internal Medicine
Education
Albany Medical College of Union University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians

Practice addresses (Care Compare)

1720 SE 16TH Ave
Suite 303
Ocala, FL 34471-4620
Phone (352) 369-0288

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Prostate resection1-10
Upper gastrointestinal (GI) endoscopy for acid reflux11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME111240FLMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Nov 6, 2013 Accepting new patients
Florida Hospital Physician Group Inc Surgery CurrentSince Aug 1, 2018 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Nov 6, 2013 Accepting new patients

Locations

8550 NE 138th Ln
Bldg 400
Lady Lake, FL 32159
Phone (352) 674-4102

1720 SE 16th Ave
Ste 303
Ocala, FL 34471
Phone (352) 368-1661

1627 SW 1st Ave
Ste 100
Ocala, FL 34471
Phone (352) 368-1661

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jgutierrez72877@adventhealth.direct-ci.com

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.

Hospital & facility affiliations 1

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": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1194978932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 SE 16TH AVE STE 303",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714620",
            "telephone_number": "352-368-1661",
            "fax_number": "352-867-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 SE 16TH AVE STE 303",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714620",
            "telephone_number": "352-368-1661",
            "fax_number": "352-867-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-24",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME111240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004133900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.