NPIMap

Individual provider Active NPI

Paul A Guttuso, MD

  • Family Medicine Physician
  • Mabank, TX
National Provider Identifier
1649210659
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K5546 Issued in TX
Practice address
604 S 3Rd St Ste a
Mabank, TX 75147-2727
Phone
(903) 887-1073
Fax
(903) 887-0496
NPI assigned
Jun 7, 2006
Last updated
Sep 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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 K5546 TX Primary
Sports Medicine (Family Medicine) Physician 207QS0010X K5546 TX

Addresses

Primary practice location

604 S 3Rd St Ste a
Mabank, TX 75147-2727

Mailing address

604 S 3Rd St Ste a
Mabank, TX 75147-2727
Phone (903) 887-1073

Other identifiers 3

IdentifierTypeStateIssuer
144327702MedicaidTX
144327703MedicaidTX
144327704MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050304000164 TX Practitioner - Family PracticePractitioner - Interventional RadiologyPractitioner - Sports Medicine 2567437767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
State University of New York at Buffalo School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

604 S 3Rd St
Mabank, TX 75147-2700
Phone (903) 887-1073

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Mar 24, 2009 Accepting new patients
Texas Health Physicians Group Family Medicine CurrentSince Mar 24, 2009 Accepting new patients
Memorial Hermann Health System Family Medicine Past Accepting new patients
Texas Health Physicians Group Family Medicine Past Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

604 S 3rd St
Mabank, TX 75147
Phone (903) 887-1073

604 S 3rd St
Ste A
Mabank, TX 75147
Phone (903) 603-5400

Interoperability endpoints

  • Direct secure messaging: pguttuso31032@direct.texashealth.org

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1649210659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 S 3RD ST STE A",
            "city": "MABANK",
            "state": "TX",
            "postal_code": "751472727",
            "telephone_number": "903-887-1073",
            "fax_number": "903-887-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S 3RD ST STE A",
            "city": "MABANK",
            "state": "TX",
            "postal_code": "751472727",
            "telephone_number": "903-887-1073",
            "fax_number": "903-887-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTUSO",
        "first_name": "PAUL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K5546",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "K5546",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144327702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144327703",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144327704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mabank, TX

Sources for this page

Verify at the official NPI Registry.