Individual provider Active NPI

Ingrid L Gutierrez, M.D.

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1457714859
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME140501 Issued in FL
Practice address
13707 SW 152ND St
Miami, FL 33177-1106
Phone
(305) 585-9200
NPI assigned
Apr 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X ME140501 FL
Family Medicine Physician 207Q00000X ME140501 FL Primary

Addresses

Primary practice location

13707 SW 152ND St
Miami, FL 33177-1106

Mailing address

13707 SW 152ND St
Miami, FL 33177-1106
Phone (305) 585-9200

Other names 1

  • Ingrid L Gutierrez-Villa Former name

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
I20191004000754 FL Practitioner - Family Practice 1658602727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York Medical College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Health Trust of Miami Dade County FloridaGroup PAC ID 8628981925, 56 clinicians

Practice addresses (Care Compare)

13707 SW 152 St
Uhealth Jackson Urgent Care Country Walk
Miami, FL 33177-1106
Phone (305) 585-9200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME140501FLMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Health Trust of Miami Dade County Florida Current Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Aug 22, 2019 Accepting new patients
Public Health Trust of Miami Dade County Florida CurrentSince Aug 22, 2019 Accepting new patients

Locations

18910 S Dixie Hwy
Cutler Bay, FL 33157
Phone (305) 585-9230

13707 SW 152nd St
Miami, FL 33177
Phone (305) 585-9200

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1457714859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13707 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771106",
            "telephone_number": "305-585-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13707 SW 152ND ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331771106",
            "telephone_number": "305-585-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "INGRID",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME140501",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME140501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INGRID",
            "last_name": "GUTIERREZ-VILLA",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.