Mario Gutierrez, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3345TG Issued in TX

Practice address

5212 Broadway St
San Antonio, TX 78209-5712

Phone

(210) 829-8083

Fax

(210) 822-4011

NPI assigned

Sep 16, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Texas Vision Associates, P.a.Group PAC ID 4385531359, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Texas Vision Associates, P.a.

  • Optometrist
  • San Antonio, TX
  • NPI 1306969670
  Medicare reassignment Care Compare group NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831295955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5212 BROADWAY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782095712",
            "telephone_number": "210-829-8083",
            "fax_number": "210-822-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5212 BROADWAY ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782095712",
            "telephone_number": "210-829-8083",
            "fax_number": "210-822-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3345TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135221306",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louis Robert Gutierrez, MD
• Marco Gutierrez
• Marco Alonso Gutierrez, MD
• Margaret Naomi Gutierrez, RN
• Maria Teresa Gutierrez, RPH
• Mario Alberto Gutierrez
• Martha Lilia Gutierrez, LVN
• Melissa Marie Gutierrez, BCBA
• Michelle Gutierrez, RN
• Monique Gutierrez

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.