Active NPI
Mary Lou Gutierrez, MD
- Psychiatry Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036107891
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036107891 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD.MD.70038835 | WA | MD | Psychiatry Physician |
| 339808 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Care Center, LLC | Current | Accepting new patients | |
| Family Care Center, LLC | Psychiatry | Current | Accepting new patients |
| MCCD FL Psychiatry Services PA | Psychiatry | Current | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Colorado Springs, CO
- NPI 1790141984
-
- Psychiatry Physician
- Mesa, AZ
- NPI 1598535288
-
- General Practice Physician
- Maywood, IL
- NPI 1235148891
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.