Priscilla Gutierrez, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95025795 Issued in CA

Practice address

630 S Brawley Ave Ste 10
Brawley, CA 92227-3107

Phone

(760) 623-1202

NPI assigned

Oct 2, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tyson Medical IncGroup PAC ID 3072870112, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Tyson Medical Inc

  • Family Medicine Physician
  • Calexico, CA
  • NPI 1467241570
  Medicare reassignment Care Compare group NPD
• Tyson Medical Inc

  • Urgent Care Clinic/Center
  • El Centro, CA
  • NPI 1376053843
  NPD

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1720868334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "467 D ST APT 1",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922271980",
            "telephone_number": "760-235-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S BRAWLEY AVE STE 10",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922273107",
            "telephone_number": "760-623-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "PRISCILLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95025795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariza Goycoolea
• Ajanamjot K Grewal, MD
• Egbert Fitzstephen Grinage Jr., MD
• Vidhi Gupta
• Alba Gutierrez, PAC
• Susan Junghee Hahm, M.D.
• Michael V Hall, CRNA
• Darius V Halliday, DDS
• Mostafa A Hamdy, MD
• Roukaya Tarek Hassanein, MD

• Nurse Practitioner in Brawley, CA
• Providers in Brawley, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.