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DR. MARIO GUTIERREZ M.D.
NPI 1801283635
Student in an Organized Health Care Education/Training Program in Peoria, IL

Active since April 20, 2015PECOS EnrolledAccepts Medicare Assignment
1109 W MAIN ST APT 505, PEORIA, IL 61606(714) 349-5704 Get Directions Write a Review

NPPES record last updated: December 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 6, 2021, Oct 21, 2019 (2 updates tracked since 2019).

About Dr. Mario Gutierrez M.d. NPPES

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

DR. MARIO GUTIERREZ M.D. (NPI 1801283635) is an individual student in an organized health care education/training program in Peoria, Illinois and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1801283635
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. MARIO GUTIERREZCredential: M.D.
Location Address1109 W MAIN ST APT 505Peoria, IL 61606-1385
Mailing Address13571 Mashona AveChino, CA 91710-8345 · (714) 349-5704
Phone(714) 349-5704
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateApril 20, 2015
Last NPPES UpdateDecember 6, 20212 updates tracked since enumeration
✔ NPI 1801283635 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1109 W MAIN ST APT 505, Peoria, IL 61606
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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

Dr. Mario 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 ID4082046651
PECOS Enrollment IDI20191120000856
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.

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 Mario Gutierrez's NPI number?

The NPI number for Mario Gutierrez is 1801283635. It was assigned to this individual provider in the NPPES registry on April 20, 2015.

Where is Mario Gutierrez located?

Mario Gutierrez practices at 1109 W Main St Apt 505, Peoria, IL 61606. The listed phone number is (714) 349-5704.

What is Mario Gutierrez's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mario Gutierrez enrolled in Medicare?

Yes. Mario 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.

When was this NPI record last updated?

The NPPES record for Mario Gutierrez was last updated on December 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.