Individual provider Active NPI

Mary Lou Gutierrez, MD

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1992913412
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036107891 Issued in IL
Practice address
109 W 27TH St RM 5S
New York, NY 10001-6208
Phone
(917) 634-5311
Fax
(888) 815-3583
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X MD.MD.70038835 WA
Child & Adolescent Psychiatry Physician 2084P0804X DR.0072520 CO
Psychiatry Physician 2084P0800X MD.MD.70038835 WA
Child & Adolescent Psychiatry Physician 2084P0804X 036107891 IL
Psychiatry Physician 2084P0800X DR.0072520 CO
Psychiatry Physician 2084P0800X 036107891 IL Primary

Addresses

Primary practice location

109 W 27TH St RM 5S
New York, NY 10001-6208

Mailing address

109 W 27TH St RM 5S
New York, NY 10001-6208
Phone (917) 634-5311

Other practice location 1

2373 Central Park Blvd Unit 100
Denver, CO 80238-2300
Phone (720) 806-1559

Other identifiers 1

IdentifierTypeStateIssuer
036107891MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, CO2 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
I20040427001508 IL Practitioner - Psychiatry 7113914649
I20240315001500 CO Practitioner - Psychiatry 7113914649 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Loyola University of Chicago, Stritch School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

2860 S Circle Dr
Colorado Springs, CO 80906-4195
Phone (719) 540-2100

9135 Ridgeline Blvd
Suite 160
Highlands Ranch, CO 80129-2395
Phone (719) 540-2100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.MD.70038835WAMDPsychiatry Physician
339808NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC CurrentSince Mar 1, 2024 Accepting new patients
Family Care Center, LLC Psychiatry CurrentSince Mar 1, 2024 Accepting new patients
MCCD FL Psychiatry Services PA Psychiatry CurrentSince Sep 22, 2025 Accepting new patients
Loyola University Physician Foundation Past Accepting new patients

Locations

9362 Grand Cordera Pkwy
Ste 100
Colorado Springs, CO 80924
Phone (719) 345-0429

2860 S Circle Dr
Ste 310
Colorado Springs, CO 80906

3715 Parkmoor Village Dr
Ste 102
Colorado Springs, CO 80917
Phone (719) 540-2127

6566 N Marksheffel Rd
#100
Colorado Springs, CO 80923
Phone (719) 297-7646

9524 Federal Dr
Ste 120
Colorado Springs, CO 80921
Phone (719) 394-3352

2860 S Circle Dr
Fl 4
Colorado Springs, CO 80906
Phone (719) 540-2146

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

4660 Yosemite St
Ste 201
Denver, CO 80238
Phone (303) 872-1740

2373 Central Park Blvd
Unit 100
Denver, CO 80238
Phone (303) 531-8310

63 N Quebec St
Ste 201
Denver, CO 80230
Phone (303) 248-7897

1525 Raleigh St
Ste 500
Denver, CO 80204
Phone (303) 872-1735

3351 Eastbrook Dr
Ste 200
Fort Collins, CO 80525
Phone (970) 500-0164

350 Indiana St
Ste 300
Golden, CO 80401
Phone (303) 248-7899

9135 Ridgeline Blvd
Ste 160
Highlands Ranch, CO 80129
Phone (303) 800-6093

13402 W Coal Mine Ave
Ste 110
Littleton, CO 80127
Phone (303) 248-7894

10535 Park Meadows Blvd
Ste 200
Lone Tree, CO 80124
Phone (303) 228-8958

363 Centennial Pkwy
Ste 220
Louisville, CO 80027
Phone (303) 879-9074

1880 Fall River Dr
Ste 250
Loveland, CO 80538
Phone (970) 775-8626

11990 Grant St
Ste 101
Northglenn, CO 80233
Phone (303) 537-8152

10120 Twenty Mile Rd
Ste 100
Parker, CO 80134
Phone (303) 228-8871

471 S Baldwin St
Ste 200
Woodland Park, CO 80863

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1992913412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "917-634-5311",
            "fax_number": "888-815-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "917-634-5311",
            "fax_number": "888-815-3583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2373 Central Park Blvd Unit 100",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802382300",
            "country_code": "US",
            "telephone_number": "720-806-1559",
            "fax_number": "888-815-3583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MARY LOU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD.MD.70038835",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "DR.0072520",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD.MD.70038835",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036107891",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0072520",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036107891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107891",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.