Individual provider Active NPI

Michelle Villanueva Gutierrez

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Miami, FL
National Provider Identifier
1629571062
Registry record updated Mar 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
9111144 Issued in FL
Practice address
3100 SW 62ND Ave
Miami, FL 33155-3009
Phone
(305) 662-8357
NPI assigned
Mar 12, 2018
Last updated
Mar 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X PA9111144 FL
Physician Assistant 363A00000X 9111144 FL
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 9111144 FL Primary

Addresses

Primary practice location

3100 SW 62ND Ave
Miami, FL 33155-3009

Mailing address

420 NW 166TH Ave
Pembroke Pines, FL 33028-1403

Other practice location 1

8900 N Kendall Dr
Miami, FL 33176-2118
Phone (786) 596-2000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818000749 FL Practitioner - Physician Assistant 5799101093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as apm
Quality
81.94
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9111144FLMDPediatric Emergency Medicine (Pediatrics) 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": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711152000000",
    "number": "1629571062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 NW 166TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330281403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009",
            "telephone_number": "305-662-8357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8900 N Kendall Dr",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331762118",
            "country_code": "US",
            "telephone_number": "786-596-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MICHELLE",
        "middle_name": "VILLANUEVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-12",
        "last_updated": "2024-03-23",
        "certification_date": "2024-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "PA9111144",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111144",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "9111144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.