DR. ALBERTO HECTOR GUTIERREZ JR. M.D.
NPI 1447260013
Family Medicine in Edinburg, TX

NPI Status: Active since August 08, 2006

Contact Information

1601 E SPRAGUE ST
EDINBURG, TX
ZIP 78542
Phone: (956) 378-9290
Fax: (956) 378-9376

NPI Profile Information
Primary Taxonomy
Medicare Participation & PECOS Status
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Family Medicine
PECOS Enrolled
Medicare Quality Reporting

About ALBERTO GUTIERREZ

This page provides the complete NPI Profile along with additional information for Alberto Gutierrez, a primary care provider established in Edinburg, Texas with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1447260013 assigned on August 2006. The practitioner's primary taxonomy code is 207Q00000X with license number D3247 (TX). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI: 1447260013
Provider Name: DR. ALBERTO HECTOR GUTIERREZ JR. M.D.
Gender: Male
Entity Type: Individual
Location Address: 1601 E SPRAGUE ST EDINBURG, TX 78542
Location Phone: (956) 378-9290
Location Fax: (956) 378-9376
Mailing Address: 1601 E SPRAGUE ST EDINBURG, TX 78542
Mailing Phone: (956) 378-9290
Mailing Fax: (956) 378-9376
Is Sole Proprietor?: No
Enumeration Date: 08-08-2006
Last Update Date: 02-02-2017
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A primary care provider (PCP) like Alberto Gutierrez sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Family Medicine
Taxonomy Code: 207Q00000X
Type: Allopathic & Osteopathic Physicians
License No.: D3247
License State: TX
Taxonomy Description: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Medicare Participation & PECOS Enrollment Status

Alberto Gutierrez is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 78542 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $84.92
Minimum New Patient Price $54.84
Maximum New Patient Price $166.88

Average New Patient Copayment $21.23
Minimum New Patient Copayment $13.71
Maximum New Patient Copayment $41.72

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $97.05
Minimum Established Patient Price $17.52
Maximum Established Patient Price $136.11

Average Established Patient Copayment $24.26
Minimum Established Patient Copayment $4.38
Maximum Established Patient Copayment $34.02

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	95%	44
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Screening for Depression and Follow-Up Plan	83%	29
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	4	4	7	2	6	0	0	1	3
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	4	8	7	4	6	0	0	2
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 8 + 7 + 4 + 6 + 0 + 0 + 2 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 3									3

The NPI number 1447260013 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.