Individual provider Active NPI

Carlos Omar Aguiar Gutierrez, MD

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1962993774
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
21687 Issued in PR
Practice address
672 Calle Manzanillo
Venus Gardens
San Juan, PR 00926
Phone
(787) 362-9849
NPI assigned
May 29, 2018
Last updated
May 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 21687 PR Primary

Addresses

Primary practice location

672 Calle Manzanillo
Venus Gardens
San Juan, PR 00926

Mailing address

672 Calle Manzanillo
Venus Gardens
San Juan, PR 00926
Phone (787) 362-9849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200921002007 PR Practitioner - General Practice 3678991866 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21687PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Zenith Health Group LLC Single Specialty CurrentSince Nov 1, 2025 Accepting new patients
Centro Medico del Turabo Inc Single Specialty CurrentSince Aug 4, 2020 Accepting new patients
MM Health Services LLC Single Specialty CurrentSince Oct 20, 2025 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Aug 4, 2020 Accepting new patients
MM Health Services, LLC. CurrentSince Oct 20, 2025 Accepting new patients
Dla Imaging LLC Single Specialty PastSince Sep 17, 2023 Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1962993774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 CALLE MANZANILLO",
            "address_2": "VENUS GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-362-9849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 CALLE MANZANILLO",
            "address_2": "VENUS GARDENS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-362-9849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUIAR GUTIERREZ",
        "first_name": "CARLOS",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.