Active NPI
Gaston Alba Gutierrez, NP
- Family Nurse Practitioner
- Albuquerque, NM
National Provider Identifier
1275695538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 01771
- Practice address
- 4201 Montano Rd NW
Albuquerque, NM 87120-5743 - Phone
- (505) 866-3892
- NPI assigned
- Dec 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 01771 | NM | Primary |
Addresses
Primary practice location
4201 Montano Rd NW
Albuquerque, NM 87120-5743
Mailing address
85 West Highway 22
Santo Domingo, NM 87052
Phone (505) 464-3060
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24755761 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01771 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Felipe Health Clinic | Past | Accepting new patients | |
| Cochiti Health Clinic | Past | Accepting new patients | |
| Kewa Pueblo Health Corporation | Past | Accepting new patients | |
| Santo Domingo Health Clinic | Past | Accepting new patients |
Interoperability endpoints
- gaston.gutierrez.1@20765.direct.athenahealth.com
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Cochiti Pueblo, NM
- NPI 1093814691
-
- Community/Behavioral Health Agency
- Santo Domingo Pueblo, NM
- NPI 1336659077
-
- General Acute Care Hospital
- San Felipe, NM
- NPI 1831274851
-
- General Acute Care Hospital
- Santo Domingo Pueblo, NM
- NPI 1376632695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1275695538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 WEST HIGHWAY 22",
"city": "SANTO DOMINGO",
"state": "NM",
"postal_code": "87052",
"telephone_number": "505-464-3060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 MONTANO RD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871205743",
"telephone_number": "505-866-3892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "GASTON",
"middle_name": "ALBA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NM",
"license": "01771",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "24755761",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.