NPIMap

Individual provider Active NPI

Stefan H. Gutow, M.D.

  • Specialist
  • Albuquerque, NM
National Provider Identifier
1386691772
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD2008-0667 Issued in NM
Practice address
610 Broadway Blvd NE
Albuquerque, NM 87102-2372
Phone
(505) 242-3991
Fax
(505) 243-8405
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD2008-0667 NM Primary
Urology Physician 208800000X MD2008-0667 NM

Addresses

Primary practice location

610 Broadway Blvd NE
Albuquerque, NM 87102-2372

Mailing address

610 Broadway Blvd NE
Albuquerque, NM 87102-2372
Phone (505) 242-3991

Other identifiers 1

IdentifierTypeStateIssuer
01132504MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081120000371 NM Practitioner - Urology 4486697091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

201 Cedar St SE
Suite 5600
Albuquerque, NM 87106-4920
Phone (505) 563-6000

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021
  • Unm Hospital Hospital, Albuquerque, NM, CCN 320001
  • Presbyterian Santa Fe Medical Center Hospital, Santa Fe, NM, CCN 320090
  • Socorro General Hospital Hospital, Socorro, NM, CCN 321301

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2008-0667NMMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince May 1, 2018 Accepting new patients
Presbyterian Healthcare Services CurrentSince May 1, 2018 Accepting new patients
Maryland Urology Associates, PA Specialist Past Accepting new patients
Chesapeake Urology Associates, LLC Urology Past Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

201 Cedar St SE
Ste 5660
Albuquerque, NM 87106
Phone (505) 563-6565

201 Cedar St SE
Ste 5600
Albuquerque, NM 87106
Phone (505) 554-7836

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: sgutow8437@ahs.direct-ci.com
  • Direct secure messaging: sgutow66707@direct.phs.org

Organizations & group practices 5

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 6

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1386691772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-242-3991",
            "fax_number": "505-243-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 BROADWAY BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022372",
            "telephone_number": "505-242-3991",
            "fax_number": "505-243-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTOW",
        "first_name": "STEFAN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "MD2008-0667",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NM",
            "license": "MD2008-0667",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01132504",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.