Individual provider Active NPI

Colleen Kays Gutman

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Gainesville, FL
National Provider Identifier
1598007528
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
ME144544 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3901
Phone
(352) 265-5911
Fax
(352) 265-5606
NPI assigned
Mar 16, 2013
Last updated
Jan 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60368530 WA
Pediatrics Physician 208000000X ME144544 FL
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X ME144544 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3901

Mailing address

1600 SW Archer Rd Box 100186
Gainesville, FL 32610-3901
Phone (352) 265-5911

Other practice location 1

4800 Sand Point Way NE
Oc.7.830
Seattle, WA 98105-3901
Phone (206) 987-2525

Other identifiers 1

IdentifierTypeStateIssuer
106379600MedicaidFL

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
I20201020002872 FL Practitioner - Pediatric Medicine 0941520217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60368530WAMDPediatrics Physician
ME144544FLMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Sep 15, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Sep 15, 2020 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

1600 SW Archer Rd
#100186
Gainesville, FL 32610

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

Interoperability endpoints

  • Direct secure messaging: cgutman72407@direct.shands.ufl.edu

Organizations & group practices 2

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": "1363392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1598007528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD BOX 100186",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103901",
            "telephone_number": "352-265-5911",
            "fax_number": "352-265-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103901",
            "telephone_number": "352-265-5911",
            "fax_number": "352-265-5606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE",
            "address_2": "OC.7.830",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-2525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTMAN",
        "first_name": "COLLEEN",
        "middle_name": "KAYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-16",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60368530",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME144544",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME144544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106379600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.