Individual provider Active NPI

Rafael Gutierrez, MD

  • Internal Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1447825856
Registry record updated Jun 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME168403 Issued in FL
Practice address
1309 S Federal Hwy
Fort Lauderdale, FL 33316-2040
Phone
(954) 463-4383
Fax
(954) 463-8174
NPI assigned
May 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME168403 FL Primary

Addresses

Primary practice location

1309 S Federal Hwy
Fort Lauderdale, FL 33316-2040

Mailing address

1309 S Federal Hwy
Fort Lauderdale, FL 33316-2040
Phone (954) 463-4383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240723004675 FL Practitioner - Internal Medicine 2567863111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Cincinnati College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

2850 N Federal Hwy
Pompano Beach Internal Medicine
Lighthouse Point, FL 33064-6849
Phone (954) 942-8177

Hospital & facility affiliations

  • Holy Cross Hospital Hospital, Ft Lauderdale, FL, CCN 100073
  • Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME168403FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital, Inc CurrentSince Jul 1, 2024 Accepting new patients
Holy Cross Hospital Inc Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

1309 S Federal Hwy
Ft Lauderdale, FL 33316
Phone (954) 463-4383

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

2850 N Federal Hwy
Pompano Beach, FL 33064
Phone (954) 785-8285

Interoperability endpoints

  • Direct secure messaging: rgutierrez2016850@direct.trinity-health.org

Organizations & group practices 2

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 5

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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718409600000",
    "number": "1447825856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 S FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162040",
            "telephone_number": "954-463-4383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 S FEDERAL HWY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162040",
            "telephone_number": "954-463-4383",
            "fax_number": "954-463-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-26",
        "last_updated": "2024-06-15",
        "certification_date": "2024-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME168403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.