JOSE GUTIERREZ – Clinical Social Worker, NPI 1245684125

JOSE GUTIERREZ is a healthcare provider. based in Salt lake city, Utah. specializing in Clinical Social Worker. The NPI Number for JOSE GUTIERREZ is 1245684125

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
JOSE GUTIERREZ
NPI
1245684125
Phone
(888) 949-4864
Address
4460 S HIGHLAND DR
Enumeration Date
18 April 2016
Last Update Date
18 April 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8012736316
Graduation Year
1999 (27 years ago)
PAC ID
2466740873
Group Practice PAC ID
0042121196
Professional Enrollment ID
I20161017002805
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:10State licenses:0Digital endpointsOther names

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Provider Addresses for JOSE GUTIERREZ

  • 4460, Highland Drive, Millcreek, Salt Lake County, Utah, 84124, United States

    230

    SALT LAKE CITY, UT 841243543

    Phone: (888) 949-4864

    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: 2016-10-17

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
I20161017002805IClinical Social WorkerUTTBD

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 84124)

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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: 0042121196View full group profile

Reviews

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Frequently asked questions

How do payers reference JOSE GUTIERREZ?
For JOSE GUTIERREZ, use NPI 1245684125 as the unique 10-digit identifier.
Is there an active status for JOSE GUTIERREZ?
For scheduling context, JOSE GUTIERREZ is shown as active in the registry.
What expertise is attributed to JOSE GUTIERREZ?
JOSE GUTIERREZ's specialty line reads Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JOSE GUTIERREZ?
Travel planning: use Salt Lake City, Utah as the reference point for JOSE GUTIERREZ, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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