Jaclyn Rene Gutierrez

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1095990 Issued in TX

Practice address

720 W 34TH St # 104
Austin, TX 78705-1205

Phone

(512) 261-4800

NPI assigned

Oct 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Infusions LLCGroup PAC ID 6608054044, 102 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Innovative Infusions, LLC

  • Infusion Therapy Clinic/Center
  • Dallas, TX
  • NPI 1811299944
  Medicare reassignment Care Compare group NPD
• Innovative Infusions, LLC

  • Infusion Therapy Clinic/Center
  • Indianapolis, IN
  • NPI 1093512246
  NPD

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1578288189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S MOPAC EXPY APT 837",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787467965",
            "telephone_number": "832-865-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W 34TH ST # 104",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051205",
            "telephone_number": "512-261-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JACLYN",
        "middle_name": "RENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1095990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danica Alitzel Gutierrez, RN
• Diego A Gutierrez
• Dina Gutierrez, LMT
• Emily Gutierrez, DNP, CPNP, IFM-CP
• Genaro Jesus Gutierrez, M.D.
• Jene Gutierrez, LMFT ASSOCIATE
• Jennifer Marie Gutierrez, MA
• Joan Azael Gutierrez
• Joann Gutierrez, PTA
• Julia Gutierrez, MD

• Family Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.