Jose Gutierrez Jr.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6716 Issued in CT

Practice address

59 Grenier St
Building 1507
Hanscom AFB, MA 01731

Phone

(339) 202-6423

NPI assigned

Sep 14, 2016

Last updated

Sep 14, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cornell Scott Hill Health Corporation

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1902921380
  Medicare reassignment NPD

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1962950378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 STATE ST",
            "address_2": "APT 2618",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103601",
            "telephone_number": "309-335-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 GRENIER ST",
            "address_2": "BUILDING 1507",
            "city": "HANSCOM AFB",
            "state": "MA",
            "postal_code": "01731",
            "telephone_number": "339-202-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JOSE",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-14",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Alan Gameros, PSYCHOLOGIST
• John David Gerhauser, DMD
• Frank Allen Glenn, PHYSICAL THERAPIST
• Ryan Gray, MD
• Ryan R Gustafson, D.D.S
• George Charles Hludzik, DMD
• Caroline Moreira Hoehene, PA-C
• Kellie Maureen Holovac, MD
• Curtis Jason Howell, APA-C
• Christopher R Jones, DDS

• Family Nurse Practitioner in Hanscom AFB, MA
• Providers in Hanscom AFB, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.