Renu Gautam, MD
NPI 1558744417 · Family Medicine Physician · Jacksonville, FL
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Renu Gautam, MD is a Family Medicine Physician provider in Jacksonville, FL (NPI 1558744417).
Provider details
- NPI number
- 1558744417
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- ME133283 (FL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 10550 Deerwood Park Blvd Ste 609aJacksonville, FL 32256-0596Phone: (904) 513-3954
Registry dates
- Enumerated
- 2015-07-09
- Last updated
- 2024-11-18
- Certified
- 2024-11-18
Frequently asked questions
- What is Renu Gautam's NPI number?
- Renu Gautam's National Provider Identifier (NPI) is 1558744417, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Renu Gautam's specialty?
- Renu Gautam is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Renu Gautam located?
- Renu Gautam's practice location on file with NPPES is 4500 San Pablo Rd S, Jacksonville, FL 32224-1865.
- What is Renu Gautam's phone number?
- The practice phone number listed in the NPPES registry for Renu Gautam is (904) 953-2000.
- Does Renu Gautam accept Medicare?
- Renu Gautam is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Renu Gautam's NPI active?
- Yes — Renu Gautam's NPI (1558744417) is active in the NPPES registry as of the last update on 2024-11-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.