ONTAYA ACEDO (LMSW) – Clinical Social Worker, NPI 1104436062

ONTAYA ACEDO (LMSW) is a healthcare provider. based in Pocatello, Idaho. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. LMSW-39736 (ID). The NPI Number for ONTAYA ACEDO (LMSW) is 1104436062

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
ONTAYA ACEDO (LMSW)
NPI
1104436062
Phone
Not provided
Address
151 N 3RD AVE STE 330
Enumeration Date
5 August 2020
Last Update Date
31 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2082423771
Graduation Year
2020 (6 years ago)
PAC ID
3870022411
Group Practice PAC ID
3870776610
Professional Enrollment ID
I20250127000526
Address ID
ID832016369PO151XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

633 CLINICAL SOCIAL WORKER in ID

Provider Addresses for ONTAYA ACEDO (LMSW)

  • 151 N 3RD AVE STE 330

    POCATELLO, ID 832016369

    Phone:

    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: 2025-01-27

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
I20250127000526IClinical Social WorkerIDTBD

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 83201)

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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: 3870776610View full group profile
NameSpecialtyState
Clinical Social WorkerID
Clinical Social WorkerID
Clinical Social WorkerID
Clinical Social WorkerID

Reviews

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Frequently asked questions

How is ONTAYA ACEDO (LMSW) identified in CMS data?
CMS-hosted NPPES data lists ONTAYA ACEDO (LMSW) with NPI 1104436062.
Can I rely on ONTAYA ACEDO (LMSW) being an active provider?
As of the registry snapshot, ONTAYA ACEDO (LMSW) is marked active.
What is ONTAYA ACEDO (LMSW)'s specialty?
The listing groups ONTAYA ACEDO (LMSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What address line appears for ONTAYA ACEDO (LMSW)?
ONTAYA ACEDO (LMSW)'s geographic hint is Pocatello, Idaho in our summary view.
Is the information about ONTAYA ACEDO (LMSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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