Individual provider Active NPI

Lizandra Gutierrez, APRN

  • Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1649735010
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
347321 Issued in NY
Practice address
181 Intrepid LN
Syracuse, NY 13205-2548
Phone
(315) 498-5430
Fax
(315) 299-5138
NPI assigned
Feb 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 347321 NY Primary

Addresses

Primary practice location

181 Intrepid LN
Syracuse, NY 13205-2548

Mailing address

181 Intrepid LN
Syracuse, NY 13205-2548
Phone (315) 498-5430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191001000534 FL Practitioner - Nurse Practitioner 9032449244 Reassigns benefits to 1 organization
I20201221002338 NY Practitioner - Nurse Practitioner 9032449244 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
347321NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Services of Syracuse CurrentSince Nov 14, 2020 Accepting new patients
South Broward Hospital District CurrentSince Aug 15, 2019 Accepting new patients
South Broward Hospital District CurrentSince Aug 15, 2019 Accepting new patients

Locations

1150 N 35th Ave
Ste 390
Hollywood, FL 33021
Phone (954) 265-7450

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

181 Intrepid Ln
Syracuse, NY 13205
Phone (315) 498-5430

Interoperability endpoints

  • Direct secure messaging: lgutierrez209116@mhsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1649735010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 INTREPID LN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052548",
            "telephone_number": "315-498-5430",
            "fax_number": "315-299-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 INTREPID LN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052548",
            "telephone_number": "315-498-5430",
            "fax_number": "315-299-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "LIZANDRA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-09",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "347321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.