Individual provider Active NPI

Ivette Guttmann, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Miami, FL
National Provider Identifier
1346534906
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
ME115053 Issued in FL
Practice address
1400 NW 12TH Ave
Miami, FL 33136-1003
Phone
(352) 978-3565
NPI assigned
Jun 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 266602 NY
Sports Medicine (Family Medicine) Physician 207QS0010X 266602 NY
Pediatrics Physician 208000000X ME115053 FL
Sports Medicine (Family Medicine) Physician 207QS0010X ME115053 FL Primary

Addresses

Primary practice location

1400 NW 12TH Ave
Miami, FL 33136-1003

Mailing address

1400 NW 12TH Ave
Miami, FL 33136-1003
Phone (352) 978-3565

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT, MA, TX4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20121219000072 NY Practitioner - Sports MedicinePractitioner - Pediatric Medicine 0143472217
I20181212001097 VT Practitioner - Sports MedicinePractitioner - Pediatric Medicine 0143472217 Reassigns benefits to 2 organizations
I20190926000286 MA Practitioner - Sports Medicine 0143472217 Reassigns benefits to 1 organization
I20250224001689 TX Practitioner - Sports Medicine 0143472217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc. 375 clinicians

Practice addresses (Care Compare)

2210 Three Lakes Pkwy
Suite 100
Tyler, TX 75703-0642
Phone (903) 747-4050

Hospital & facility affiliations

  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
266602NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Vermont Medical Center, Inc CurrentSince Jan 1, 2019 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2025 Accepting new patients
Northern Berkshire Medical, PC CurrentSince Jul 6, 2019 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2025 Accepting new patients
Southwestern Vermont Medical Center, Inc CurrentSince Jan 1, 2019 Accepting new patients
Southwestern Vermont Medical Center Inc. Pediatrics Current Accepting new patients
Southwestern Vermont Medical Center Inc. CurrentSince Jan 1, 2019 Accepting new patients
Radiology Associates of North Texas PA Past Accepting new patients

Locations

375 Main St
Williamstown, MA 01267
Phone (413) 398-1000

16 Danforth St
Hoosick Falls, NY 12090
Phone (518) 686-5002

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

2210 Three Lakes Pkwy
Ste 100
Tyler, TX 75703
Phone (903) 747-4050

332 Dewey St
Bennington, VT 05201
Phone (802) 442-2034

100 Hospital Dr
Bennington, VT 05201
Phone (802) 447-4509

100 Hospital Dr
#44
Bennington, VT 05201
Phone (802) 442-4509

140 Hospital Dr
Ste 116
Bennington, VT 05201
Phone (802) 447-1836

5957 Main St
Manchestr Ctr, VT 05255
Phone (802) 362-4440

Interoperability endpoints

  • Direct secure messaging: iguttmann1339715@ahs.direct-ci.com

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1346534906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "352-978-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "352-978-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTMANN",
        "first_name": "IVETTE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "266602",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NY",
            "license": "266602",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME115053",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME115053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.