Individual provider Active NPI

Gutteridge Jean-Charles, MD

  • Internal Medicine Physician
  • Orlando, FL
National Provider Identifier
1598803470
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME102281 Issued in FL
Practice address
1781 Park Center Drive
Suite 120
Orlando, FL 32835-6254
Phone
(407) 914-2325
Fax
(407) 826-1592
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 211338 NY
Internal Medicine Physician 207R00000X ME102281 FL Primary

Addresses

Primary practice location

1781 Park Center Drive
Suite 120
Orlando, FL 32835-6254

Mailing address

P.O. Box 617440
Orlando, FL 32861
Phone (407) 914-2325

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
I20120912000085 FL Practitioner - Internal MedicinePractitioner - Pain Management 3577711803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pain Management
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1781 Park Ctr Dr
Suite 120
Orlando, FL 32835-6254
Phone (407) 914-2325

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211338NYMDInternal Medicine Physician

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, 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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1598803470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 617440",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32861",
            "telephone_number": "407-914-2325",
            "fax_number": "407-826-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 PARK CENTER DRIVE",
            "address_2": "SUITE 120",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356254",
            "telephone_number": "407-914-2325",
            "fax_number": "407-826-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN-CHARLES",
        "first_name": "GUTTERIDGE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2024-03-29",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "211338",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME102281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.