Individual provider Active NPI

Melissa E. Gutierrez, MD

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1215976840
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A81438 Issued in CA
Practice address
100 S Anaheim Blvd Ste 101
Anaheim, CA 92805-3848
Phone
(714) 826-1200
Fax
(714) 665-4652
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A81438 CA Primary

Addresses

Primary practice location

100 S Anaheim Blvd Ste 101
Anaheim, CA 92805-3848

Mailing address

100 S Anaheim Blvd Ste 101
Anaheim, CA 92805-3848
Phone (714) 826-1200

Other identifiers 1

IdentifierTypeStateIssuer
00A8114380MedicaidCA

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
I20041005000832 CA Practitioner - Family Practice 6002875119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorialcare Medical FoundationGroup PAC ID 8729277314, 555 clinicians

Practice addresses (Care Compare)

100 S Anaheim Blvd
Suite 101
Anaheim, CA 92805-3848
Phone (714) 826-1200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
814380CAMDRegistered Dietitian
A81438CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
San Gorgonio Memorial Hospital Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Bristol Park Medical Group, Inc Family Medicine Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Children'S Hospital of Orange County Past Accepting new patients

Locations

100 S Anaheim Blvd
Ste 101
Anaheim, CA 92805
Phone (714) 826-1200

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mgutierrez136729@direct.memorialcare.org

Organizations & group practices 9

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 2

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1215976840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S ANAHEIM BLVD STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053848",
            "telephone_number": "714-826-1200",
            "fax_number": "714-665-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ANAHEIM BLVD STE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053848",
            "telephone_number": "714-826-1200",
            "fax_number": "714-665-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MELISSA",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A81438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A8114380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.