Individual provider Active NPI

Andrew Gutowski, D.O.

  • Anesthesiology Physician
  • Stoughton, MA
National Provider Identifier
1396846911
Registry record updated Dec 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
75081 Issued in MA
Practice address
907 Sumner St
M201
Stoughton, MA 02072
Phone
(781) 344-2325
Fax
(781) 341-8544
NPI assigned
Sep 26, 2006
Last updated
Dec 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 75081 MA Primary

Addresses

Primary practice location

907 Sumner St
M201
Stoughton, MA 02072

Mailing address

907 Sumner St
M201
Stoughton, MA 02072
Phone (781) 344-2325

Other identifiers 1

IdentifierTypeStateIssuer
110055102AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20041008000937 MA Practitioner - Anesthesiology 4385619568 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
On Demand Anesthesia LLCGroup PAC ID 0042675662, 20 clinicians
South Suburban Gastroenterology PCGroup PAC ID 9931194412, 50 clinicians

Practice addresses (Care Compare)

700 Attucks LN
Unit 1B
Hyannis, MA 02601-1813
Phone (781) 585-9522

97 Libbey Pkwy
Suite 300
Weymouth, MA 02189-3110
Phone (781) 331-2922

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Suburban Gastroenterology, PC CurrentSince May 13, 2020 Accepting new patients
On Demand Anesthesia LLC Anesthesiology CurrentSince Jul 25, 2023 Accepting new patients
Weymouth Endoscopy, LLC PastSince May 13, 2020 Accepting new patients
Anesthesiology Assoc of Taunton Inc Anesthesiology PastSince Aug 31, 2004 Accepting new patients

Locations

700 Attucks Ln
Unit 1B
Hyannis, MA 02601
Phone (508) 367-3557

1085 Main St
Weymouth, MA 02190
Phone (781) 331-2922

97 Libbey Park
Ste 300
Weymouth, MA 02189
Phone (781) 331-2922

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291593600000",
    "number": "1396846911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 SUMNER ST",
            "address_2": "M201",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "02072",
            "telephone_number": "781-344-2325",
            "fax_number": "781-341-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 SUMNER ST",
            "address_2": "M201",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "02072",
            "telephone_number": "781-344-2325",
            "fax_number": "781-341-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTOWSKI",
        "first_name": "ANDREW",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "75081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110055102A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, MA

Sources for this page

Verify at the official NPI Registry.