NPIMap

Individual provider Active NPI

Cory Gutovitz

  • Internal Medicine Physician
  • Westwood, KS
National Provider Identifier
1750810099
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0443614 Issued in KS
Practice address
2650 Shawnee Mission Pkwy Ste 2201
Westwood, KS 66205-2003
Phone
(913) 588-9800
Fax
(913) 588-9803
NPI assigned
Jun 9, 2017
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9409275 KS
Internal Medicine Physician 207R00000X 0443614 KS Primary

Addresses

Primary practice location

2650 Shawnee Mission Pkwy Ste 2201
Westwood, KS 66205-2003

Mailing address

2650 Shawnee Mission Pkwy Ste 2201
Westwood, KS 66205-2003
Phone (913) 588-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20201110002972 KS Practitioner - Internal Medicine 9436421971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jayhawk Primary Care IncGroup PAC ID 8123928900, 157 clinicians

Practice addresses (Care Compare)

2650 Shawnee Mission Pkwy
Suite 2201
Westwood, KS 66205-2003
Phone (913) 588-9800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0443614KSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jayhawk Primary Care Inc Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
Jayhawk Primary Care Inc Internal Medicine Current Accepting new patients
Jayhawk Primary Care Inc Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients
University of Kansas Hospital Authority PastSince Apr 17, 2022 Accepting new patients
Jayhawk Primary Care Inc Past Accepting new patients

Locations

11300 Corporate Ave
Ste 330
Lenexa, KS 66219
Phone (913) 588-6111

7405 Renner Rd
Shawnee Msn, KS 66217
Phone (913) 588-2200

Interoperability endpoints

  • Direct secure messaging: cgutovitz297991@direct.kuha.org

Organizations & group practices 5

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 12

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": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1750810099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 SHAWNEE MISSION PKWY STE 2201",
            "city": "WESTWOOD",
            "state": "KS",
            "postal_code": "662052003",
            "telephone_number": "913-588-9800",
            "fax_number": "913-588-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 SHAWNEE MISSION PKWY STE 2201",
            "city": "WESTWOOD",
            "state": "KS",
            "postal_code": "662052003",
            "telephone_number": "913-588-9800",
            "fax_number": "913-588-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTOVITZ",
        "first_name": "CORY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-09",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "9409275",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0443614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, KS

Sources for this page

Verify at the official NPI Registry.