Individual provider Active NPI

Dominic Gutierrez, D.C.

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1780003004
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2066 Issued in NM
Practice address
6001 Winter Haven Dr NW
Suite H
Albuquerque, NM 87120-1745
Phone
(505) 724-9000
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2066 NM Primary

Addresses

Primary practice location

6001 Winter Haven Dr NW
Suite H
Albuquerque, NM 87120-1745

Mailing address

6001 Winter Haven Dr NW
Suite H
Albuquerque, NM 87120-1745
Phone (505) 724-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908000380 NM Practitioner - Chiropractic 8325266208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Mexico Chiropractic Center PCGroup PAC ID 0749381143, 3 clinicians

Practice addresses (Care Compare)

10555 Montgomery Blvd NE
BLDG 1 Suite 30
Albuquerque, NM 87111-3857
Phone (505) 299-6622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2066NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico Chiropractic Center PC Chiropractor CurrentSince Sep 4, 2014 Accepting new patients

Locations

10555 Montgomery Blvd NE
Ste 30
Albuquerque, NM 87111
Phone (505) 299-6622

Organizations & group practices 1

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1780003004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 WINTER HAVEN DR NW",
            "address_2": "SUITE H",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201745",
            "telephone_number": "505-724-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 WINTER HAVEN DR NW",
            "address_2": "SUITE H",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201745",
            "telephone_number": "505-724-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "2066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.