DR. MARIO CLARK GUTIERREZ (M.D.) – Anesthesiology Physician, NPI 1538142823

DR. MARIO CLARK GUTIERREZ (M.D.) is a healthcare provider. based in Jacksonville, Florida. specializing in Anesthesiology Physician. They hold the professional credentials M.D.. They hold a License No. ME93706 (FL). The NPI Number for DR. MARIO CLARK GUTIERREZ (M.D.) is 1538142823

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARIO CLARK GUTIERREZ (M.D.)
NPI
1538142823
Phone
(904) 953-2000
Address
4500 SAN PABLO RD S
Enumeration Date
21 November 2005
Last Update Date
2 September 2014

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Secondary Phone
8664812553
Graduation Year
2004 (22 years ago)
PAC ID
0143253328
Group Practice PAC ID
0840238432
Professional Enrollment ID
I20050917000154
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. MARIO CLARK GUTIERREZ (M.D.)

  • San Pablo Road South, San Pablo, Jacksonville, Duval County, Florida, 32224, United States

    JACKSONVILLE, FL 322241865

    Phone: (904) 953-2000

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-09-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050917000154IAnesthesiologyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32224)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840238432View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. MARIO CLARK GUTIERREZ (M.D.)?
DR. MARIO CLARK GUTIERREZ (M.D.) — NPI 1538142823 — is the standard way to identify this listing.
Does CMS list DR. MARIO CLARK GUTIERREZ (M.D.) as active?
Yes — DR. MARIO CLARK GUTIERREZ (M.D.) is active in the NPI listing used on this page.
What is DR. MARIO CLARK GUTIERREZ (M.D.) best known for clinically?
Directory data describes DR. MARIO CLARK GUTIERREZ (M.D.) with Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
Where should I expect DR. MARIO CLARK GUTIERREZ (M.D.) on a map?
Expect Jacksonville, Florida as a primary anchor for DR. MARIO CLARK GUTIERREZ (M.D.) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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