Individual provider Active NPI

Jeannine Gutierrez, O.D.

  • Optometrist
  • Coral Gables, FL
National Provider Identifier
1790169472
Registry record updated Jan 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5099 Issued in FL
Practice address
2500 S Douglas Rd
Coral Gables, FL 33134-6104
Phone
(305) 443-7070
NPI assigned
Jul 13, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5099 FL Primary

Addresses

Primary practice location

2500 S Douglas Rd
Coral Gables, FL 33134-6104

Mailing address

755 N Rock Island Rd
Margate, FL 33063-4328

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170530002509 FL Practitioner - Optometry 3779850425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Doctors Optical Outlets PAGroup PAC ID 0042123846, 97 clinicians

Practice addresses (Care Compare)

3740 Park Blvd N
Pinellas Park, FL 33781-3611
Phone (727) 547-4856

5607 Johns Rd
Tampa, FL 33634-4499
Phone (813) 385-1873

6927 4TH St N
Saint Petersburg, FL 33702-6846
Phone (727) 210-8672

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Optometry, PA CurrentSince Dec 13, 2021 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Sep 1, 2021 Accepting new patients
Eye Doctors Optical Outlets PA Optometrist CurrentSince Sep 1, 2021 Accepting new patients
National Vision, Inc. Past Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

2109 66th St N
St Petersburg, FL 33710
Phone (727) 342-5226

3520 4th St N
St Petersburg, FL 33704
Phone (727) 369-0043

5607 Johns Rd
Tampa, FL 33634
Phone (813) 385-1873

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jgutierrez242373@oce.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1790169472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N ROCK ISLAND RD",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330634328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S DOUGLAS RD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331346104",
            "telephone_number": "305-443-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JEANNINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.