ILITCH DIAZ GUTIERREZ M.D.
NPI 1629209366
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Maplewood, MN

Q: What is Ilitch Diaz Gutierrez's NPI number?

The NPI number for Ilitch Diaz Gutierrez is 1629209366. It was assigned to this individual provider in the NPPES registry on July 29, 2009.

Q: What is Ilitch Diaz Gutierrez's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Active since July 29, 2009PECOS EnrolledAccepts Medicare Assignment

82.34/100

CMS Quality Rating

1655 BEAM AVE STE 302, MAPLEWOOD, MN 55109(651) 227-6351 Get Directions Write a Review

NPPES record last updated: August 30, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 30, 2018, Jun 22, 2016 (2 updates tracked since 2016).

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About Ilitch Diaz Gutierrez M.d. NPPES

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

ILITCH DIAZ GUTIERREZ M.D. (NPI 1629209366) is an individual thoracic surgery (cardiothoracic vascular surgery) provider in Maplewood, Minnesota, licensed in Minnesota (63088) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS, is affiliated with M Health Fairview University Of Mn, and maintains a secondary practice location in Minneapolis.

NPPES Registry Identity

NPI1629209366

Entity TypeIndividualMale

Primary Taxonomy208G00000X

Provider Legal NameILITCH DIAZ GUTIERREZCredential: M.D.

Location Address1655 BEAM AVE STE 302Maplewood, MN 55109-1477

Mailing Address3144 Chowen Ave S, Apt 219bMinneapolis, MN 55416-5398 · (505) 818-7180

Phone(651) 227-6351

Sole ProprietorYes

Medical School CMSOtherGraduated 2007

Enumeration DateJuly 29, 2009

Last NPPES UpdateAugust 30, 20182 updates tracked since enumeration

✔ NPI 1629209366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyThoracic Surgery (Cardiothoracic Vascular Surgery)Allopathic & Osteopathic Physicians

Taxonomy Code208G00000X

License✔ Licensed in MN · 63088

Definition

A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.

Also ListedSurgeryTaxonomy 208600000X · License RS2009-0378 (NM)

1655 BEAM AVE STE 302, Maplewood, MN 55109

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Secondary Practice Location 1

Location 1500 Harvard St SEMinneapolis, MN 55455-0363 · Phone (612) 273-3000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.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

Ilitch Diaz 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 ID7911132105

PECOS Enrollment IDI20180522002742

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 2

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.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

11 services11 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

M Health Fairview University Of Mn

Acute Care Hospitals · Minneapolis, MN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number240080

Location2450 Riverside AvenueMinneapolis, MN 55454 · Hennepin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55109 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

$168.28 typical visit price

range $56.00 – $168.28

Typical copayment $42.07 (range $14.00 – $42.07)

Most-billed visit code 99205

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

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.

82.34/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

81.54

Promoting Interoperability

100

Improvement Activities

Cost

38.17

Other Providers at the Same Location NPPES 3

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

DR. PETER B WILTON MD

Surgery

1655 BEAM AVE STE 302
MAPLEWOOD, MN 55109

Ramsey County (651) 227-6351

PATRICIA LYNN RICHMAN MD

Family Medicine

1655 BEAM AVE STE 302
MAPLEWOOD, MN 55109

Ramsey County (612) 221-6034

ASHLEY TIX RD, LD

Dietitian, Registered

1655 BEAM AVE STE 302
MAPLEWOOD, MN 55109

Ramsey County (651) 726-2058

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 Ilitch Diaz Gutierrez's NPI number?

The NPI number for Ilitch Diaz Gutierrez is 1629209366. It was assigned to this individual provider in the NPPES registry on July 29, 2009.

Where is Ilitch Diaz Gutierrez located?

Ilitch Diaz Gutierrez practices at 1655 Beam Ave Ste 302, Maplewood, MN 55109. The listed phone number is (651) 227-6351.

What is Ilitch Diaz Gutierrez's specialty?

The primary specialty registered for this NPI is Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.

Is Ilitch Diaz Gutierrez enrolled in Medicare?

Yes. Ilitch Diaz 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 Ilitch Diaz Gutierrez accept?

Health plans from Medica and Sanford Health Plan list Ilitch Diaz 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 Ilitch Diaz Gutierrez affiliated with any hospitals?

According to CMS data, Ilitch Diaz Gutierrez is affiliated with M Health Fairview University Of Mn.

When was this NPI record last updated?

The NPPES record for Ilitch Diaz Gutierrez was last updated on August 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.