NPIMap

Individual provider Active NPI

Wilson Sy Gutierrez, MD

  • Hospitalist Physician
  • Roseburg, OR
National Provider Identifier
1962694802
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD28542 Issued in OR
Practice address
2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone
(541) 673-0611
NPI assigned
Aug 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD28542 OR
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X MD28542 OR
Hospitalist Physician 208M00000X MD28542 OR Primary

Addresses

Primary practice location

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281

Mailing address

2774 NW Daysha Dr
Roseburg, OR 97471-2980
Phone (541) 784-6233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081009000174 OR Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Hospice/Palliative Care 0345318911 Reassigns benefits to 3 organizations
I20220520001969 CA Practitioner - Hospitalist 0345318911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Hospice/Palliative Care, Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galen Inpatient Physicians PCGroup PAC ID 3678464633, shared by 11 NPIs, 1,045 clinicians

Practice addresses (Care Compare)

1000 3Rd St
Tillamook, OR 97141-3430
Phone (503) 842-4444

726 4TH St
Marysville, CA 95901-5656
Phone (530) 749-4300

Hospital & facility affiliations

  • Mercy Medical Center Hospice Hospice, Roseburg, OR, CCN 381521
  • Mercy Medical Center Hospital, Roseburg, OR, CCN 380027
  • Adventist Health Tillamook Hospital, Tillamook, OR, CCN 381317

Merit-based Incentive Payment System (MIPS)

Final score
82.4 of 100Reported as group
Quality
65.6
Improvement activities
40
Cost
71.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD28542ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Galen Inpatient Physicians PC Internal Medicine CurrentSince Jun 1, 2022 Accepting new patients
Galen Inpatient Physicians, PC Hospitalist Current Accepting new patients
Galen Inpatient Physicians PC Internal Medicine CurrentSince May 15, 2014 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince May 15, 2014 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

10123 SE Market St
Portland, OR 97216
Phone (503) 251-6355

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

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.

Hospital & facility affiliations 6

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1962694802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2774 NW DAYSHA DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712980",
            "telephone_number": "541-784-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711281",
            "telephone_number": "541-673-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "WILSON",
        "middle_name": "SY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD28542",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "OR",
            "license": "MD28542",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD28542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.