NPIMap

Organization Active NPI

Jose R. Gutierrez MD PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Acton, MA
National Provider Identifier
1851987663
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
JOSE R. GUTIERREZ MD PC
Practice address
1 Great Rd
Acton, MA 01720-5601
Phone
(978) 263-9101
NPI assigned
Dec 15, 2020
Last updated
Dec 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Authorized official

Name
Jose R. Gutierrez, MDNPI 1437377967
Title
President
Phone
(646) 537-5170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

1 Great Rd
Acton, MA 01720-5601

Mailing address

10 Eagles Nest Rd
Westford, MA 01886-1396
Phone (646) 537-5170

Other practice location 1

191 Foster St
Littleton, MA 01460-2018
Phone (978) 486-3512

Other practice location 2

80 Boston Rd
North Billerica, MA 01862-1034
Phone (978) 667-2166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210414001433 MA Part B Supplier - Clinic/Group Practice 9830507763 Receives reassigned benefits from 22 practitioners
Practice locations: Acton, MA; Westford, MA

National Provider Directory

National Provider Directory

Locations

1 Great Rd
#20
Acton, MA 01720

57 Old Road To 9 Acre Cor
Unit 4
Concord, MA 01742

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1851987663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 EAGLES NEST RD",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018861396",
            "telephone_number": "646-537-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GREAT RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017205601",
            "telephone_number": "978-263-9101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "191 Foster St",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "MA",
            "postal_code": "014602018",
            "country_code": "US",
            "telephone_number": "978-486-3512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Boston Rd",
            "address_purpose": "LOCATION",
            "city": "North Billerica",
            "state": "MA",
            "postal_code": "018621034",
            "country_code": "US",
            "telephone_number": "978-667-2166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOSE R. GUTIERREZ MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-537-5170",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.