NPIMap

Individual provider Active NPI

Miguel A Gutierrez, MD

  • Family Medicine Physician
  • Weatherford, TX
National Provider Identifier
1881629624
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L2915 Issued in TX
Practice address
1517 Texas Dr
Weatherford, TX 76086-6327
Phone
(817) 458-3300
Fax
(817) 458-3370
NPI assigned
Jul 11, 2006
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L2915 TX Primary

Addresses

Primary practice location

1517 Texas Dr
Weatherford, TX 76086-6327

Mailing address

1517 Texas Dr
Weatherford, TX 76086-6327
Phone (817) 458-3300

Other identifiers 2

IdentifierTypeStateIssuer
148305902MedicaidTX
148305904MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL miguel.gutierrez.1@9877.direct.athenahealth.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040421000499 TX Practitioner - Family PracticePractitioner - Emergency Medicine 1951397504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Parker County Hospital DistrictGroup PAC ID 0840269163, 10 clinicians

Practice addresses (Care Compare)

1517 Texas Dr
Weatherford, TX 76086-6327
Phone (817) 458-3342

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L2915TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Parker County Hospital District CurrentSince Jan 3, 2019 Accepting new patients
Parker County Hospital District CurrentSince Jan 3, 2019 Accepting new patients
Physicians and Allied Health Professionals Group, PA Family Medicine Past Accepting new patients
Parker County Hospital District Past Accepting new patients

Locations

1517 Texas Dr
Weatherford, TX 76086
Phone (817) 458-3300

Interoperability endpoints

  • Direct secure messaging: miguel.gutierrez.1@9877.direct.athenahealth.com

Organizations & group practices 4

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 4

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1881629624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 TEXAS DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866327",
            "telephone_number": "817-458-3300",
            "fax_number": "817-458-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 TEXAS DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760866327",
            "telephone_number": "817-458-3300",
            "fax_number": "817-458-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MIGUEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L2915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148305902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148305904",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "miguel.gutierrez.1@9877.direct.athenahealth.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1517 Texas Dr",
            "city": "Weatherford",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760866327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

Verify at the official NPI Registry.