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

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: August 16, 2026.

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

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
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

Accepted 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

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.

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.

Rehabilitation Unit
430 WATERSTONE DR
HILLSBOROUGH, NC 27278
Pharmacist
430 WATERSTONE DR
HILLSBOROUGH, NC 27278
Registered Nurse
430 WATERSTONE DR
HILLSBOROUGH, NC 27278
Student in an Organized Health Care Education/Training Program
430 WATERSTONE DR
HILLSBOROUGH, NC 27278
Occupational Therapist
430 WATERSTONE DR
HILLSBOROUGH, NC 27278
Obstetrics & Gynecology
430 WATERSTONE DR
HILLSBOROUGH, NC 27278
Physical Therapist
430 WATERSTONE DR
HILLSBOROUGH, NC 27278
Nurse Practitioner (Primary Care)
430 WATERSTONE DR
HILLSBOROUGH, NC 27278

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 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.

Where is Roberto Sanchez Gutierrez located?

Roberto Sanchez Gutierrez practices at 430 Waterstone Dr, Hillsborough, NC 27278. The listed phone number is (910) 715-2164.

What is Roberto Sanchez Gutierrez's specialty?

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

Is Roberto Sanchez Gutierrez enrolled in Medicare?

Yes. Roberto Sanchez 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 Roberto Sanchez Gutierrez accept?

Health plans from Blue Cross and Blue Shield of Texas and Oscar Insurance Company list Roberto Sanchez 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.

Is Roberto Sanchez Gutierrez affiliated with any hospitals?

According to CMS data, Roberto Sanchez Gutierrez is affiliated with Kona Community Hospital.

When was this NPI record last updated?

The NPPES record for Roberto Sanchez Gutierrez was last updated on March 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.