ANGELO GUTIERREZ – Family Nurse Practitioner, NPI 1063205672

ANGELO GUTIERREZ is a healthcare provider. based in Pasadena, California. specializing in NURSE PRACTITIONER. They hold a License No. 95035225 (CA). The NPI Number for ANGELO GUTIERREZ is 1063205672

Main info

Male
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
ANGELO GUTIERREZ
NPI
1063205672
Phone
(615) 766-6711
Address
540 N OAKLAND AVE
Enumeration Date
27 May 2025
Last Update Date
27 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3234412139
Graduation Year
2025 (1 year ago)
PAC ID
8729594437
Group Practice PAC ID
2961482690
Professional Enrollment ID
I20250721001388
Address ID
CA900312457LO2512XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

16,353 NURSE PRACTITIONER in CA

Provider Addresses for ANGELO GUTIERREZ

  • 540 N OAKLAND AVE

    PASADENA, CA 911011112

    Phone: (615) 766-6711

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250721001388INurse PractitionerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91101)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961482690View full group profile
NameSpecialtyState
Nurse PractitionerCA
Nurse PractitionerCA
Internal MedicineNY
Physician AssistantDC
-CA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA
Nurse PractitionerCA

Reviews

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Frequently asked questions

What unique ID ties claims to ANGELO GUTIERREZ?
NPI 1063205672 is assigned to ANGELO GUTIERREZ under the national enumeration system.
Is ANGELO GUTIERREZ currently active in the NPI registry?
CMS-published data lists ANGELO GUTIERREZ as an active registrant.
Does ANGELO GUTIERREZ list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for ANGELO GUTIERREZ. Clinical services aligned with this taxonomy classification.
Where does public data place ANGELO GUTIERREZ?
The snapshot lists Pasadena, California for ANGELO GUTIERREZ; download NPPES for the complete set.
Is ANGELO GUTIERREZ a real provider?
This page reflects official NPPES data for NPI 1063205672. Always confirm identity and privileges with the practice and licensing boards.

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