Individual provider Active NPI

Eddy Jose Gutierrez, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Jacksonville, FL
National Provider Identifier
1790042513
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
ME132154 Issued in FL
Practice address
1443 San Marco Blvd Ste 101
Jacksonville, FL 32207-8535
Phone
(904) 253-6910
Fax
(904) 253-6964
NPI assigned
Apr 18, 2012
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 84110 GA
Internal Medicine Physician 207R00000X ME132154 FL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 84110 GA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME132154 FL Primary

Addresses

Primary practice location

1443 San Marco Blvd Ste 101
Jacksonville, FL 32207-8535

Mailing address

1443 San Marco Blvd Ste 101
Jacksonville, FL 32207-8535
Phone (904) 253-6910

Other identifiers 1

IdentifierTypeStateIssuer
20495400MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address egutierrez321027@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170523002885 FL Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 5597074278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1325 San Marco Blvd
Jacksonville, FL 32207-8568
Phone (904) 253-6910

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.86 of 100Reported as group
Quality
85.7
Promoting interoperability
100
Improvement activities
40
Cost
78.45

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME132154FLMDCritical Care Medicine (Internal Medicine) Physician
84110GAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Respiratory Critical Care and Sleep Medicine Associates,Inc CurrentSince Jun 1, 2017 Accepting new patients

Locations

1325 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 253-6910

1325 San Marco Blvd
Ste 300
Jacksonville, FL 32207
Phone (904) 202-4243

1443 San Marco Blvd
Ste 101
Jacksonville, FL 32207
Phone (904) 253-6910

Interoperability endpoints

  • Direct secure messaging: eddygutierrez@rccsma.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1790042513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 SAN MARCO BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078535",
            "telephone_number": "904-253-6910",
            "fax_number": "904-253-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 SAN MARCO BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078535",
            "telephone_number": "904-253-6910",
            "fax_number": "904-253-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "EDDY",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "84110",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME132154",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "84110",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME132154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20495400",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "egutierrez321027@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4700 Waters Ave Ste 507",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "31404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.