ROBERTO SANCHEZ GUTIERREZ M.D.
NPI 1164625182
Hospitalist in Hillsborough, NC

Q: What is Roberto Sanchez Gutierrez's NPI number?

The NPI number for Roberto Sanchez Gutierrez is 1164625182. It was assigned to this individual provider in the NPPES registry on June 7, 2007.

Q: What is Roberto Sanchez Gutierrez's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Active since June 07, 2007PECOS EnrolledAccepts Medicare Assignment

430 WATERSTONE DR, HILLSBOROUGH, NC 27278(910) 715-2164(910) 715-4493 Get Directions Write a Review

NPPES record last updated: March 7, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 13, 2016, Aug 16, 2016 (2 updates tracked since 2016).

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About Roberto Sanchez Gutierrez M.d. NPPES

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

ROBERTO SANCHEZ GUTIERREZ M.D. (NPI 1164625182) is an individual hospitalist provider in Hillsborough, North Carolina, licensed in North Carolina (2013-01217) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Kona Community Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1164625182

Entity TypeIndividualMale

Primary Taxonomy208M00000X

Provider Legal NameROBERTO SANCHEZ GUTIERREZCredential: M.D.

Location Address430 WATERSTONE DRHillsborough, NC 27278-9078

Mailing Address213 Bingham Ridge DrPittsboro, NC 27312-8443 · (512) 633-9170 · Fax (910) 715-1026

Phone(910) 715-2164

Fax(910) 715-4493

Sole ProprietorYes

Medical School CMSOtherGraduated 2002

Enumeration DateJune 7, 2007

Last NPPES UpdateMarch 7, 20172 updates tracked since enumeration

✔ NPI 1164625182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in NC · 2013-01217

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 2013-01217 (NC)

430 WATERSTONE DR, Hillsborough, NC 27278

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Cigna Healthcare, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Roberto Sanchez Gutierrez M.d. 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 ID6608064472

PECOS Enrollment IDI20170726003314

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.

Medicare Billing Reassignments

Medicare enrollment records show Roberto Sanchez Gutierrez reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fhpg, LLC

20 mi

Family Medicine

40 RAMSEUR RD STE 102
Pittsboro, NC 27312

Reassigned Medicare billing, North Carolina enrollment
333 clinicians in this Medicare group

NPI 1447911490 (919) 545-0580

Hospitalist Medicine Physicians Of North Carolina PLLC

39 mi

Internal Medicine

1200 N ELM ST, 5TH FLOOR
Greensboro, NC 27401

Reassigned Medicare billing, North Carolina enrollment
254 clinicians in this Medicare group

NPI 1164724902 (336) 832-5777

Sound Physicians Of North Carolina, PLLC

159 mi

Hospitalist

1144 N ROAD ST
Elizabeth City, NC 27909

Reassigned Medicare billing, North Carolina enrollment
77 clinicians in this Medicare group

NPI 1346661493 (252) 335-0531

Sound Physicians Of Hawaii Inc

4,724 mi

Internal Medicine

79-1019 HAUKAPILA ST
Kealakekua, HI 96750

Reassigned Medicare billing, Hawaii enrollment
65 clinicians in this Medicare group

NPI 1740658053 (808) 322-9311

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

303 services127 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

111 services64 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

90 services88 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

79 services78 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

77 services36 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

71 services61 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Kona Community Hospital

Acute Care Hospitals · Kealakekua, HI

1/5 CMS rating

OwnershipGovernment - State

CMS Certification Number120019

Location79-1019 Haukapila StreetKealakekua, HI 96750 · Hawaii County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27278 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

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$95.94 typical visit price

range $17.21 – $134.61

Typical copayment $23.98 (range $4.30 – $33.65)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

98%126 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers31 claims31 services$102.88 avg. paid by Medicare

Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738

DME-Oxygen and Supplies · category DC000N

2 suppliers27 claims27 services$35.12 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

UNIVERSITY OF NORTH CAROLINA HOSPITALS AT CHAPEL HILL

Rehabilitation Unit