Ernesto Gutierrez, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16627 Issued in AZ

Practice address

1260 S Campbell Ave BLDG 2
Green Valley, AZ 85614-0502

Phone

(520) 407-5400

Fax

(520) 407-5990

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Internal Medicine

Education

University of Arizona College of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marana Health Center IncGroup PAC ID 2365348091, 114 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ernesto.gutierrez.1@32652.direct.athenahealth.com

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.

• Marana Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Marana, AZ
  • NPI 1447263405

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Marana Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1396512034
  NPD
• Marana Health Center, Inc

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)
• Marana Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1295986735
  NPD (past)
• Marana Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1477612786
  NPD (past)

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1366595605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-818-3616",
            "fax_number": "520-818-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 S CAMPBELL AVE BLDG 2",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140502",
            "telephone_number": "520-407-5400",
            "fax_number": "520-407-5990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17388 W. 3rd Street",
            "address_purpose": "LOCATION",
            "city": "Arivaca",
            "state": "AZ",
            "postal_code": "85601",
            "country_code": "US",
            "telephone_number": "520-407-5500",
            "fax_number": "520-407-5990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3690 S Park Ave",
            "address_2": "# 805",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857135069",
            "country_code": "US",
            "telephone_number": "520-616-6760",
            "fax_number": "520-616-6799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "ERNESTO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "16627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277401",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Green Valley Physical Medicine, Inc
• Colleen M Green, PMHNP-BC
• Vicki L Greiff, MD
• Kathy Lynn Grindle, RN
• Garth Gruenhagen, COTA
• Keila Gutierrez, M.A.
• Juan J Guzman, MD
• GV Acupuncture LLC
• GV Hospital Management LLC
• Kimberly Mantha Hamlin, LMT

• Internal Medicine Physician in Green Valley, AZ
• Providers in Green Valley, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.