Individual provider Active NPI

Juan Carlos Martinez Gutierrez, M.D.

  • Neurology Physician
  • Roswell, GA
National Provider Identifier
1275985533
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
96832 Issued in GA
Practice address
2500 Hospital Blvd Ste 310
Roswell, GA 30076-4947
Phone
(770) 664-9600
Fax
(770) 664-9856
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X S9028 TX
Student in an Organized Health Care Education/Training Program 390200000X 268195 MA
Neurology Physician 2084N0400X 96832 GA Primary

Addresses

Primary practice location

2500 Hospital Blvd Ste 310
Roswell, GA 30076-4947

Mailing address

2500 Hospital Blvd Ste 310
Roswell, GA 30076-4947
Phone (770) 664-9600

Other practice location 1

6400 Fannin St Ste 2800
Houston, TX 77030-1534
Phone (713) 486-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmartinezgutierrez530134@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230914002757 GA Practitioner - Neurosurgery 9234424474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

2500 Hospital Blvd
Roswell, GA 30076-4947

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2912

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

61 Whitcher N E St
Suite 4120
Marietta, GA 30060-1179
Phone (770) 424-9732

61 Whitcher St NE
Suite 2100
Marietta, GA 30060-1179
Phone (770) 423-0595

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S9028TXMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

2500 Hospital Blvd
Ste 310
Roswell, GA 30076
Phone (770) 425-2695

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.

Hospital & facility affiliations 4

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1275985533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD STE 310",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764947",
            "telephone_number": "770-664-9600",
            "fax_number": "770-664-9856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL BLVD STE 310",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764947",
            "telephone_number": "770-664-9600",
            "fax_number": "770-664-9856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 Fannin St Ste 2800",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770301534",
            "country_code": "US",
            "telephone_number": "713-486-8000",
            "fax_number": "713-486-8088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ GUTIERREZ",
        "first_name": "JUAN CARLOS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "S9028",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "268195",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "96832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmartinezgutierrez530134@directwellstar.org",
            "affiliation": "N",
            "address_1": "2500 Hospital Blvd Ste 310",
            "city": "Roswell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300764947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.