Individual provider Active NPI

Fatima D. Gutierrez, M.D.

  • Pediatrics Physician
  • El Paso, TX
National Provider Identifier
1295907194
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N7805 Issued in TX
Practice address
4801 Alberta Ave
Pediatrics Dept.
El Paso, TX 79905-2707
Phone
(915) 545-6755
Fax
(915) 545-6975
NPI assigned
Mar 31, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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 N7805 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

4801 Alberta Ave
Pediatrics Dept.
El Paso, TX 79905-2707

Mailing address

4800 Alberta Ave
Suite 101
El Paso, TX 79905-2709
Phone (915) 545-6720

Other identifiers 2

IdentifierTypeStateIssuer
TXB157279OtherTXMEDICARE
220165903MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120801000836 TX Practitioner - Pediatric Medicine 1456507771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of New Mexico School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N7805TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Texas Tech University Health Sciences Center El Paso Pediatrics CurrentSince Jul 27, 2012 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Jul 27, 2012 Accepting new patients
El Paso Children'S Hospital Corporation Past Accepting new patients

Locations

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

4800 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5666

4800 Alberta Ave
Ste 101
El Paso, TX 79905
Phone (915) 215-4478

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.

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1295907194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 ALBERTA AVE",
            "address_2": "SUITE 101",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052709",
            "telephone_number": "915-545-6720",
            "fax_number": "915-545-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 ALBERTA AVE",
            "address_2": "PEDIATRICS DEPT.",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052707",
            "telephone_number": "915-545-6755",
            "fax_number": "915-545-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "FATIMA",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N7805",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "TXB157279",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220165903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.