Active NPI
Gina Marie Makouske, CSW
- Social Worker
- Salt Lake City, UT
National Provider Identifier
1487220224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 12236527-3502
- Practice address
- 660 S 200 E
Salt Lake City, UT 84111-3835 - Phone
- (801) 359-2256
- NPI assigned
- Jun 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 12236527-3502 | UT | Primary |
Addresses
Primary practice location
660 S 200 E
Salt Lake City, UT 84111-3835
Mailing address
660 S 200 E
Salt Lake City, UT 84111-3835
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230111002507 | TX | Practitioner - Clinical Social Worker | 8729458542 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Confederated Tribes of the Goshute Reservation
Practice addresses (Care Compare)
660 S 200 E
250 Sacred Cir Hlthcare
Salt Lake City, UT 84111-3846
Phone (801) 395-2256
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12236527-3502 | UT | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Confederated Tribes of the Goshute Reservation | Current | Accepting new patients | |
| Confederated Tribes of the Goshute Reservation | Current | Accepting new patients |
Locations
195 Tribal Center Rd
Ibapah, UT 84034
Phone (435) 234-1302
660 S 200 E
Slc, UT 84111
Phone (801) 355-1528
660 S 200 E
Ste 250
Slc, UT 84111
Phone (801) 395-2256
Organizations & group practices 2
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.
-
- General Practice Physician
- Ibapah, UT
- NPI 1750510277
TX
-
- Clinic/Center
- Salt Lake City, UT
- NPI 1992141964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1487220224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S 200 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841113835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 S 200 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841113835",
"telephone_number": "801-359-2256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKOUSKE",
"first_name": "GINA",
"middle_name": "MARIE",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-02",
"last_updated": "2021-06-02",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "12236527-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.