Ilitch Diaz Gutierrez, MD - Medicare Thoracic Surgery in Maplewood, MN

Ilitch Diaz Gutierrez, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Maplewood, Minnesota. He graduated from medical school in 2007 and has 17 years of diverse experience with area of expertise as Thoracic Surgery. He is a member of the group practice Fairview Express Care, University Of Minnesota Health Clinics And Surgery Center Inc and his current practice location is 1655 Beam Ave Ste 302, Maplewood, Minnesota. You can reach out to his office (for appointments etc.) via phone at (651) 227-6351.

Ilitch Diaz Gutierrez is licensed to practice in Minnesota (license number 63088) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1629209366.

Contact Information

Ilitch Diaz Gutierrez, MD
1655 Beam Ave Ste 302,
Maplewood, MN 55109-1477
(651) 227-6351
Not Available



Physician's Profile

Full NameIlitch Diaz Gutierrez
GenderMale
SpecialityThoracic Surgery
Experience17 Years
Location1655 Beam Ave Ste 302, Maplewood, Minnesota
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Ilitch Diaz Gutierrez graduated from medical school in 2007
  NPI Data:
  • NPI Number: 1629209366
  • Provider Enumeration Date: 07/29/2009
  • Last Update Date: 08/30/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 7911132105
  • Enrollment ID: I20180522002742

Medical Identifiers

Medical identifiers for Ilitch Diaz Gutierrez such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629209366NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery RS2009-0378 (New Mexico)Secondary
208G00000XThoracic Surgery (cardiothoracic Vascular Surgery) 63088 (Minnesota)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
University Of Minnesota Medical Center, FairviewMinneapolis, MNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Fairview Express Care33756451791523
University Of Minnesota Health Clinics And Surgery Center Inc9133423304492

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ilitch Diaz Gutierrez allows following entities to bill medicare on his behalf.
Entity NameUniversity Of Minnesota Physicians
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477598118
PECOS PAC ID: 9830001189
Enrollment ID: O20031104000532

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Entity NameFairview Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1013994359
PECOS PAC ID: 1951213057
Enrollment ID: O20031105000461

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Entity NameFairview Clinics
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346432218
PECOS PAC ID: 7113830142
Enrollment ID: O20031106000516

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Entity NameRange Regional Health Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669569265
PECOS PAC ID: 8022920024
Enrollment ID: O20031110000095

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Entity NameHealtheast Medical Research Institute
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1639125503
PECOS PAC ID: 3971407636
Enrollment ID: O20031124000507

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Entity NameFairview Express Care
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053952606
PECOS PAC ID: 3375645179
Enrollment ID: O20081028000548

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Entity NameUniversity Of Minnesota Health Clinics And Surgery Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053795187
PECOS PAC ID: 9133423304
Enrollment ID: O20160209000524

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ilitch Diaz Gutierrez is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ilitch Diaz Gutierrez, MD
3144 Chowen Ave S, Apt 219b,
Minneapolis, MN 55416-5398

Ph: (505) 818-7180
Ilitch Diaz Gutierrez, MD
1655 Beam Ave Ste 302,
Maplewood, MN 55109-1477

Ph: (651) 227-6351

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Thoracic Surgery (Cardiothoracic Vascular Surgery) Doctors in Maplewood, MN


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