Individual provider Active NPI

Brian Gutshall, DO

  • Internal Medicine Physician
  • Aberdeen, WA
National Provider Identifier
1972942456
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
60645156 Issued in WA
Practice address
915 Anderson Dr
Aberdeen, WA 98520-1006
Phone
(360) 532-8330
NPI assigned
Jun 18, 2013
Last updated
Aug 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 60645156 WA Primary

Addresses

Primary practice location

915 Anderson Dr
Aberdeen, WA 98520-1006

Mailing address

970 Satsop Rd W
Montesano, WA 98563-9326

Other practice location 1

819 S 13th St
Mount Vernon, WA 98274-4112
Phone (360) 848-5527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160721000871 WA Practitioner - Internal Medicine 2466688817 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grays Harbor Community HospitalGroup PAC ID 3577462365, 91 clinicians

Practice addresses (Care Compare)

915 Anderson Dr
Aberdeen, WA 98520-1006
Phone (360) 532-8330

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60645156WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grays Harbor Community Hospital CurrentSince Jul 1, 2016 Accepting new patients
Grays Harbor Community Hospital Single Specialty Current Accepting new patients
Multicare Health System CurrentSince May 8, 2021 Accepting new patients
Grays Harbor Community Hospital CurrentSince Jul 1, 2016 Accepting new patients
Multicare Health System Single Specialty Current Accepting new patients
Multicare Health System CurrentSince May 8, 2021 Accepting new patients
Capital Medical Center Specialty Physicians, LLC Single Specialty CurrentSince Feb 16, 2018 Accepting new patients

Locations

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

Organizations & group practices 7

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 3

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": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1972942456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 SATSOP RD W",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985639326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 ANDERSON DR",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985201006",
            "telephone_number": "360-532-8330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 S 13th St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744112",
            "country_code": "US",
            "telephone_number": "360-848-5527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTSHALL",
        "first_name": "BRIAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-18",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "60645156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

Verify at the official NPI Registry.