Individual provider Active NPI

Nicole M Grigg Gutierrez, MD

  • Gastroenterology Physician
  • Harlingen, TX
National Provider Identifier
1750516035
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
Q7052 Issued in TX
Practice address
512 Victoria LN Ste 2
Harlingen, TX 78550-3227
Phone
(956) 365-4400
Fax
(956) 365-4111
NPI assigned
May 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2015-00773 NC
Internal Medicine Physician 207R00000X 18392 PR
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Q7052 TX Primary

Addresses

Primary practice location

512 Victoria LN Ste 2
Harlingen, TX 78550-3227

Mailing address

512 Victoria LN Ste 2
Harlingen, TX 78550-3227
Phone (956) 365-4400

Other practice location 1

1401 E 8th St
Weslaco, TX 78596-6640
Phone (956) 854-4342

Other practice location 2

305 Lorenaly Dr
Brownsville, TX 78526-4333
Phone (956) 365-4400

Other identifiers 2

IdentifierTypeStateIssuer
NC2408MedicaidSC
1750516035MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160809002005 TX Practitioner - Gastroenterology 3476868753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University Central del Caribe Escuela de Medicina, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gastroenterology Consultants of South Texas, PLLCGroup PAC ID 3274624937, 42 clinicians

Practice addresses (Care Compare)

512 Victoria LN
Suite 2
Harlingen, TX 78550-3227
Phone (956) 365-4400

720 N 77 Sunshinestrip
Harlingen, TX 78550-8848
Phone (956) 365-4400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy175
Upper gastrointestinal (GI) endoscopy for acid reflux341

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-00773NCMDInternal Medicine Physician
18392PRMDInternal Medicine Physician
Q7052TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiovascular Care Providers, Inc. Multi-Specialty Past Accepting new patients

Organizations & group practices 2

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 5

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": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1750516035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 VICTORIA LN STE 2",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785503227",
            "telephone_number": "956-365-4400",
            "fax_number": "956-365-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 VICTORIA LN STE 2",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785503227",
            "telephone_number": "956-365-4400",
            "fax_number": "956-365-4111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 E 8th St",
            "address_purpose": "LOCATION",
            "city": "Weslaco",
            "state": "TX",
            "postal_code": "785966640",
            "country_code": "US",
            "telephone_number": "956-854-4342",
            "fax_number": "956-854-4157",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 Lorenaly Dr",
            "address_purpose": "LOCATION",
            "city": "Brownsville",
            "state": "TX",
            "postal_code": "785264333",
            "country_code": "US",
            "telephone_number": "956-365-4400",
            "fax_number": "956-365-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIGG GUTIERREZ",
        "first_name": "NICOLE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-15",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2015-00773",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "18392",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "Q7052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2408",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750516035",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

Verify at the official NPI Registry.