DR. MARIO GUTIERREZ M.D.
NPI 1801283635
Student in an Organized Health Care Education/Training Program in Peoria, IL
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
Specialties & Licenses
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
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.
Medicare Billing Reassignment
Medicare enrollment records show Mario Gutierrez reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lancaster, CA 93534
- Reassigned Medicare billing, California enrollment
- 13,921 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Which organization bills Medicare for Mario Gutierrez's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mario Gutierrez reassigns Medicare benefits to Southern California Permanente Medical Group (Lancaster, CA). The 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 Mario Gutierrez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Dr. Mario Gutierrez, M.D. · NPI 1801283635
Student in an Organized Health Care Education/Training Program provider in Peoria, Illinois. Individual provider, active in the CMS NPPES registry since April 20, 2015.
## Identity
- **NPI:** 1801283635 (Entity type: Individual)
- **Enumerated:** April 20, 2015
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 1109 W MAIN ST APT 505, Peoria, IL 61606-1385
- **Phone:** (714) 349-5704
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Southern California Permanente Medical Group (NPI 1982863783, Lancaster, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** December 6, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1801283635) · Data from the CMS NPPES public registry.