Individual provider Active NPI

Miguel Agustin Pardinas Gutierrez, MD

  • Pulmonary Disease Physician
  • Quincy, IL
National Provider Identifier
1568876407
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
036151251 Issued in IL
Practice address
1025 Maine St
Quincy, IL 62301-4096
Phone
(217) 222-6550
NPI assigned
Jun 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036151251 IL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 036151251 IL
Pulmonary Disease Physician 207RP1001X 036151251 IL Primary

Addresses

Primary practice location

1025 Maine St
Quincy, IL 62301-4096

Mailing address

1025 Maine St
Quincy, IL 62301-4096

Other practice location 1

1611 NW 12th Ave
Miami, FL 33136-1005
Phone (305) 585-5215 ext. 3

Other practice location 2

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200527001672 IL Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 3577984640 Reassigns benefits to 3 organizations
I20260622000392 IA Practitioner - Pulmonary Disease 3577984640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

500 Messenger Rd
Keokuk, IA 52632-2117
Phone (319) 524-5321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036151251ILMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Association CurrentSince Aug 23, 2020 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jul 10, 2020 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jul 10, 2020 Accepting new patients
Blessing Hospital CurrentSince Nov 1, 2020 Accepting new patients
Blessing Hospital CurrentSince Nov 1, 2020 Accepting new patients
Memorial Hospital Association CurrentSince Aug 23, 2020 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Memorial Hospital Association Current Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Past Accepting new patients

Locations

500 Messenger Rd
Keokuk, IA 52632
Phone (319) 524-5321

1450 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-2173

1454 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-3131

320 N Madison St
Pittsfield, IL 62363
Phone (217) 285-9601

1005 Broadway St
Quincy, IL 62301

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
  • Direct secure messaging: mpardinasgutierrez748323@direct.unitypoint.org

Organizations & group practices 9

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 4

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1568876407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014096",
            "telephone_number": "217-222-6550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-585-5215 x3",
            "fax_number": "305-585-8137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1005 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012834",
            "country_code": "US",
            "telephone_number": "217-223-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARDINAS GUTIERREZ",
        "first_name": "MIGUEL",
        "middle_name": "AGUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036151251",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036151251",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036151251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.