Individual provider Active NPI

Brett Gutterman, M.D.

  • Diagnostic Radiology Physician
  • Orlando, FL
National Provider Identifier
1942461009
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME115128 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 200-2355
NPI assigned
Jun 21, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT193506 PA
Student in an Organized Health Care Education/Training Program 390200000X 004043 GA
Diagnostic Radiology Physician 2085R0202X 69415 GA
Diagnostic Radiology Physician 2085R0202X ME115128 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

2600 Westhall LN FL 4
Maitland, FL 32751-7102
Phone (407) 200-2355

Other identifiers 2

IdentifierTypeStateIssuer
14Q09OtherFLBC/BS
009016700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130703000266 FL Practitioner - Diagnostic Radiology 0547400103 Reassigns benefits to 2 organizations
I20181012001104 KY Practitioner - Diagnostic Radiology 0547400103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0042383200, 329 clinicians

Practice addresses (Care Compare)

1551 Future Way
Adventhealth Imaging
Celebration, FL 34747-4489
Phone (407) 303-4041

210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone (606) 598-5104

235 E Princeton St
Suite 100
Orlando, FL 32804-5554
Phone (407) 303-1414

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME115128FLMDDiagnostic Radiology Physician
69415GAMDDiagnostic Radiology Physician
004043GAMDStudent in an Organized Health Care Education/Training Program
MT193506PAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Radiology Imaging at Lake Mary, LLC Diagnostic Radiology CurrentSince Jul 19, 2014 Accepting new patients

Locations

900 Winderley Pl
Ste 2100
Maitland, FL 32751
Phone (407) 200-1606

235 E Princeton St
Ste 100
Orlando, FL 32804
Phone (407) 303-1414

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: bgutterman56781@adventhealth.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

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": "1214006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1942461009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 WESTHALL LN FL 4",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517102",
            "telephone_number": "407-200-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-200-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTERMAN",
        "first_name": "BRETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-21",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT193506",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "004043",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "69415",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME115128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "14Q09",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009016700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.