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IVAN MISAEL GUTIERREZ M.D
NPI 1346416864
Surgery - Pediatric Surgery in Tucson, AZ

Active since May 05, 2008PECOS EnrolledAccepts Medicare Assignment
5166 E GLENN ST, TUCSON, AZ 85712(520) 795-5338(520) 795-5382 Get Directions Write a Review

NPPES record last updated: August 18, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 18, 2021, Jan 27, 2020 (2 updates tracked since 2020).

About Ivan Misael Gutierrez M.d NPPES

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

IVAN MISAEL GUTIERREZ M.D (NPI 1346416864) is an individual pediatric surgery provider in Tucson, Arizona, licensed in Arizona (59674) and active in the NPI registry since May 2008. He is enrolled in Medicare PECOS, maintains a secondary practice location in Loma Linda, and is a graduate of Loma Linda University School Of Medicine (2008).

NPPES Registry Identity

NPI1346416864
Entity TypeIndividualMale
Primary Taxonomy2086S0120X
Provider Legal NameIVAN MISAEL GUTIERREZCredential: M.D
Location Address5166 E GLENN STTucson, AZ 85712-1337
Mailing AddressPo Box 31235Tucson, AZ 85751-1235 · (520) 324-2308
Phone(520) 795-5338
Fax(520) 795-5382
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2008
Enumeration DateMay 5, 2008
Last NPPES UpdateAugust 18, 20212 updates tracked since enumeration
NPPES CertifiedAugust 18, 2021
✔ NPI 1346416864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0120X
License✔ Licensed in AZ · 59674
Definition
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
5166 E GLENN ST, Tucson, AZ 85712
Open in Google Maps ↗

Secondary Practice Location 1

Location 111234 Anderson StLoma Linda, CA 92354-2804 · Phone (707) 337-7270

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Antidote Health Plan of Arizona, Inc. and more.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

Ivan Misael 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 ID1052547551
PECOS Enrollment IDI20200213002251
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

2

Medicare enrollment records show Ivan Gutierrez reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Children's Clinics For Rehabilitative Services
0.3 mi
Multi-Specialty
2600 N WYATT DR
Tucson, AZ 85712
  • Reassigned Medicare billing, Arizona enrollment
  • 138 clinicians in this Medicare group
NPI 1063454346 (520) 324-5437
Tmc Medical Network
0.4 mi
Multi-Specialty
5301 E GRANT RD
Tucson, AZ 85712
  • Reassigned Medicare billing, Arizona enrollment
  • 471 clinicians in this Medicare group
NPI 1750832283 (520) 327-5461

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

Other Providers at the Same Location NPPES 8

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

DERRICK LYNN JOHNSTON M.D.
Urology (Pediatric Urology)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
JANELLE LYN VESELY N.P.
Nurse Practitioner (Family)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
JEFFREY C HOEHNER
Surgery (Pediatric Surgery)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
CATHERINE M COSENTINO MD
Surgery (Pediatric Surgery)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
ARTHI HANNALLAH MD
Urology (Pediatric Urology)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
ARIZONA PEDIATRIC SURGERY LTD
Specialist
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
NANCYE SOPORITO NP
Nurse Practitioner (Pediatrics, Critical Care)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338
JONATHAN PAPIC
Surgery (Pediatric Surgery)
5166 E GLENN ST
TUCSON, AZ 85712
Pima County (520) 795-5338

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 Ivan Gutierrez's NPI number?

The NPI number for Ivan Gutierrez is 1346416864. It was assigned to this individual provider in the NPPES registry on May 5, 2008.

Where is Ivan Gutierrez located?

Ivan Gutierrez practices at 5166 E Glenn St, Tucson, AZ 85712. The listed phone number is (520) 795-5338.

What is Ivan Gutierrez's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Is Ivan Gutierrez enrolled in Medicare?

Yes. Ivan 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.

Which organizations bill Medicare for Ivan Gutierrez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ivan Gutierrez reassigns Medicare benefits to 2 organizations: Children's Clinics For Rehabilitative Services (Tucson, AZ) and Tmc Medical Network (Tucson, AZ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ivan Gutierrez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ivan Gutierrez accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and Cigna HealthCare of Arizona, Inc and 1 other insurer list Ivan 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 Ivan Gutierrez was last updated on August 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.