Individual provider Active NPI

James Robert Gutierrez, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1548554397
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4697 College View Ave
Los Angeles, CA 90041-2936
Phone
(323) 360-3173
NPI assigned
Jun 8, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4697 College View Ave
Los Angeles, CA 90041-2936

Mailing address

4697 College View Ave
Los Angeles, CA 90041-2936
Phone (323) 360-3173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120417000363 CA Practitioner - Physical Therapist in Private Practice 1759542814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Back2 Health Physical Therapy IncGroup PAC ID 8527068246, 6 clinicians

Practice addresses (Care Compare)

930 W Alameda Ave
Burbank, CA 91506-2802
Phone (818) 588-3880

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38193CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Back2 Health Physical Therapy Inc Physical Therapist CurrentSince Oct 9, 2011 Accepting new patients

Locations

930 W Alameda Ave
Burbank, CA 91506
Phone (818) 588-3880

1335 N La Brea Ave
Ste 3
Los Angeles, CA 90028
Phone (213) 297-4395

9201 W Sunset Blvd
Ste M120
West Hollywood, CA 90069
Phone (310) 246-1050

Organizations & group practices 1

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": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1548554397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4697 COLLEGE VIEW AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412936",
            "telephone_number": "323-360-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4697 COLLEGE VIEW AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412936",
            "telephone_number": "323-360-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.