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EDGAR ALLAN GUTIERREZ
NPI 1093053449
Nurse Practitioner - Family in Portland, OR

Active since January 18, 2013PECOS EnrolledAccepts Medicare Assignment
8122 SE TIBBETTS ST, PORTLAND, OR 97206(503) 255-1111 Get Directions Write a Review

NPPES record last updated: December 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edgar Allan Gutierrez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGAR ALLAN GUTIERREZ (NPI 1093053449) is an individual family provider in Portland, Oregon, licensed in Oregon (201405804NP-PP) and active in the NPI registry since January 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1093053449
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameEDGAR ALLAN GUTIERREZ
Location Address8122 SE TIBBETTS STPortland, OR 97206-1768
Mailing Address5750 Se Tranquil CtMilwaukie, OR 97267-4343
Phone(503) 255-1111
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJanuary 18, 2013
Last NPPES UpdateDecember 29, 2021
NPPES CertifiedDecember 29, 2021
✔ NPI 1093053449 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in OR · 201405804NP-PP
Also ListedRegistered NurseTaxonomy 163W00000X · License 200341187-RN (OR)
8122 SE TIBBETTS ST, Portland, OR 97206
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Kaiser Permanente.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edgar Allan Gutierrez is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143592659
PECOS Enrollment IDI20170817003958
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97206 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DREW RHYS HAVEN LMT
Massage Therapist
8122 SE TIBBETTS ST
PORTLAND, OR 97206
Multnomah County (704) 608-7777
THACH HOANG
Student in an Organized Health Care Education/Training Program
8122 SE TIBBETTS ST
PORTLAND, OR 97206
Multnomah County (503) 255-1111
PHUONG T PHAN PHARMD
Pharmacist
8122 SE TIBBETTS ST
PORTLAND, OR 97206
Multnomah County (503) 255-1111
TRIET ANH NGUYEN DO
Family Medicine
8122 SE TIBBETTS ST
PORTLAND, OR 97206
Multnomah County (503) 777-5995
EMILY SWEEDLER LMT
Massage Therapist
8122 SE TIBBETTS ST
PORTLAND, OR 97206
Multnomah County (503) 255-1111
HELEN DOAN PHARM,D.
Pharmacist
8122 SE TIBBETTS ST
PORTLAND, OR 97206
Multnomah County (503) 777-7055
MR. JASON PAUL TAYLOR PA-C
Physician Assistant
8122 SE TIBBETTS ST
PORTLAND, OR 97206
Multnomah County (503) 777-5995
WINONA-REBEKAH BLANCO MARATITA-LIZAMA
Pharmacist
8122 SE TIBBETTS ST
PORTLAND, OR 97206
Multnomah County (503) 777-7055

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgar Gutierrez's NPI number?

The NPI number for Edgar Gutierrez is 1093053449. It was assigned to this individual provider in the NPPES registry on January 18, 2013.

Where is Edgar Gutierrez located?

Edgar Gutierrez practices at 8122 SE Tibbetts St, Portland, OR 97206. The listed phone number is (503) 255-1111.

What is Edgar Gutierrez's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Edgar Gutierrez enrolled in Medicare?

Yes. Edgar Gutierrez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Edgar Gutierrez accept?

Health plans from Kaiser Permanente list Edgar Gutierrez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edgar Gutierrez was last updated on December 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.