Individual provider Active NPI

Namivian Gonzalez Gutierrez, APRN

  • Family Nurse Practitioner
  • Palm Springs, FL
National Provider Identifier
1568055515
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11011727 Issued in FL
Practice address
3145 S Congress Ave Ste a
Palm Springs, FL 33461-2553
Phone
(561) 559-2371
Fax
(561) 530-4540
NPI assigned
Feb 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11011727 FL
Family Nurse Practitioner 363LF0000X APRN11011727 FL Primary

Addresses

Primary practice location

3145 S Congress Ave Ste a
Palm Springs, FL 33461-2553

Mailing address

3145 S Congress Ave Ste a
Palm Springs, FL 33461-2553
Phone (561) 559-2371

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220125003215 FL Practitioner - Nurse Practitioner 5395137301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Soma Medical Center PA 14Group PAC ID 3072959865, 3 clinicians
Soma Medical Center, PAGroup PAC ID 2062420227, 9 clinicians

Practice addresses (Care Compare)

3145 S Congress Ave
Suite a
Palm Springs, FL 33461-2553
Phone (561) 559-2371

3255 Forest Hill Blvd
Suite 103
Palm Springs, FL 33406-5854
Phone (561) 964-4577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11011727FLMDFamily Nurse Practitioner
APRN11011727FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Soma Medical Center, PA CurrentSince Jun 17, 2024 Accepting new patients
Soma Medical Center, PA CurrentSince Jun 17, 2024 Accepting new patients
Soma Medical Center, P.a. Past Accepting new patients

Locations

3145 S Congress Ave
Ste A
Palm Springs, FL 33461
Phone (516) 814-7622

3255 Forest Hill Blvd
#103
West Palm Beach, FL 33406
Phone (561) 964-4577

3255 Forest Hill Blvd
West Palm Beach, FL 33406
Phone (561) 433-5050

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFIECD
  • FHIR API: https://fhir4.healow.com/fhir/r4/IFGECD

Organizations & group practices 4

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": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1568055515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 S CONGRESS AVE STE A",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612553",
            "telephone_number": "561-559-2371",
            "fax_number": "561-530-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 S CONGRESS AVE STE A",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334612553",
            "telephone_number": "561-559-2371",
            "fax_number": "561-530-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ GUTIERREZ",
        "first_name": "NAMIVIAN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-19",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11011727",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11011727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

Verify at the official NPI Registry.