Individual provider Active NPI

Mitsi Gutierrez Ramal, M.D.

  • Family Medicine Physician
  • Garland, TX
National Provider Identifier
1619131034
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R1038 Issued in TX
Practice address
2601 Forest LN
Garland, TX 75042-6508
Phone
(484) 860-0407
NPI assigned
Jul 15, 2008
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT192761 PA
Family Medicine Physician 207Q00000X R1038 TX Primary

Addresses

Primary practice location

2601 Forest LN
Garland, TX 75042-6508

Mailing address

6424 Bermuda Dunes Dr
Plano, TX 75093-8801
Phone (484) 860-0407

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170523000808 TX Practitioner - Family Practice 8729239082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2601 Forest LN
Garland, TX 75042-6508
Phone (484) 860-0407

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT192761PAMDFamily Medicine Physician
R1038TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vida Care Medical Center, PLLC CurrentSince Oct 15, 2024 Accepting new patients

Locations

2601 Forest Ln
Garland, TX 75042
Phone (484) 860-0407

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBDGDD/Endpoint/JBDGDD

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1619131034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6424 BERMUDA DUNES DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938801",
            "telephone_number": "484-860-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 FOREST LN",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750426508",
            "telephone_number": "484-860-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ RAMAL",
        "first_name": "MITSI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT192761",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R1038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.