USHA GAUTAM (NURSE PRACTITIONER) – Nurse Practitioner, NPI 1508665605

USHA GAUTAM (NURSE PRACTITIONER) is a healthcare provider. based in Sandy, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials NURSE PRACTITIONER. They hold a License No. 11176038-4405 (UT). The NPI Number for USHA GAUTAM (NURSE PRACTITIONER) is 1508665605

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
USHA GAUTAM (NURSE PRACTITIONER)
NPI
1508665605
Phone
(385) 234-8696
Address
243 E HAMMERMILL LN
Enumeration Date
11 March 2025
Last Update Date
11 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8014877557
Graduation Year
2024 (2 years ago)
PAC ID
8628585775
Group Practice PAC ID
1355785437
Professional Enrollment ID
I20250724003095
Address ID
UT841152221SA451XXLNXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

2,655 NURSE PRACTITIONER in UT

Provider Addresses for USHA GAUTAM (NURSE PRACTITIONER)

  • 243 E HAMMERMILL LN

    SANDY, UT 840702918

    Phone: (385) 234-8696

    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: 2025-07-24

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
I20250724003095INurse PractitionerUTTBD

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 84070)

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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: 1355785437View full group profile
NameSpecialtyState
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT
Nurse PractitionerUT
Family PracticeUT
Internal MedicineUT
Nurse PractitionerNV
Internal MedicineCO
Nurse PractitionerUT
Physician AssistantUT

Reviews

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Frequently asked questions

What unique ID ties claims to USHA GAUTAM (NURSE PRACTITIONER)?
NPI 1508665605 is assigned to USHA GAUTAM (NURSE PRACTITIONER) under the national enumeration system.
Is USHA GAUTAM (NURSE PRACTITIONER) active in the national directory?
USHA GAUTAM (NURSE PRACTITIONER)'s public NPI profile is in an active state.
What does USHA GAUTAM (NURSE PRACTITIONER) treat or focus on?
Patients typically see USHA GAUTAM (NURSE PRACTITIONER) under the specialty Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for USHA GAUTAM (NURSE PRACTITIONER)?
The page summarizes Sandy, Utah for USHA GAUTAM (NURSE PRACTITIONER); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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