Individual provider Active NPI

Svetlana T Gutierrez, M.D.

  • Internal Medicine Physician
  • Fairfield, CA
National Provider Identifier
1619990637
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A109885 Issued in CA
Practice address
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone
(707) 646-5080
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A109885 CA Primary

Addresses

Primary practice location

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552

Mailing address

1450 Treat Blvd # 300
Walnut Creek, CA 94597-2168
Phone (925) 952-2828

Other practice location 1

2700 Grant St Ste 200
Concord, CA 94520-2270
Phone (925) 974-3393

Other identifiers 1

IdentifierTypeStateIssuer
7675040600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110301000974 CA Practitioner - Internal Medicine 5496790909 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John Muir Physician NetworkGroup PAC ID 6608789813, 488 clinicians

Practice addresses (Care Compare)

2700 Grant St
Suite 200
Concord, CA 94520-2270
Phone (925) 674-0500

Hospital & facility affiliations

  • John Muir Medical Center - Walnut Creek Campus Hospital, Walnut Creek, CA, CCN 050180
  • John Muir Medical Center - Concord Campus Hospital, Concord, CA, CCN 050496

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109885CAMDClinical Social Worker
A109885CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Muir Physician Network CurrentSince Nov 2, 2022 Accepting new patients
Northbay Healthcare Group CurrentSince Jul 1, 2021 Accepting new patients
Northbay Healthcare Group CurrentSince Jul 1, 2021 Accepting new patients
Northbay Healthcare Group Current Accepting new patients
John Muir Health Past Accepting new patients
John Muir Health Past Accepting new patients
Tidalhealth Peninsula Regional, Inc. Past Accepting new patients

Locations

2400 Balfour Rd
Ste 120
Brentwood, CA 94513
Phone (925) 308-8112

2700 Grant St
Ste 200
Concord, CA 94520
Phone (925) 674-2609

2540 East St
Concord, CA 94520
Phone (925) 674-2228

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

380 Civic Dr
Ste 100
Pleasant Hill, CA 94523
Phone (925) 284-3840

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

1450 Treat Blvd
#300
Walnut Creek, CA 94597
Phone (925) 952-2828

Organizations & group practices 8

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 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1619990637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD # 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-952-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 B GALE WILSON BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333552",
            "telephone_number": "707-646-5080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Grant St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945202270",
            "country_code": "US",
            "telephone_number": "925-974-3393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "SVETLANA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A109885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7675040600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.