Jesse Gutierrez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149020119 Issued in IL

Practice address

901 N 1St St Ste 225
Springfield, IL 62702-3760

Phone

(217) 788-4065

NPI assigned

Apr 17, 2018

Last updated

Apr 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bahn and Associates IncGroup PAC ID 2860630530, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bahn and Associates Inc

  dba Behavioral Health Center of Illinois

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, IL
  • NPI 1932408929
  Medicare reassignment Care Compare group NPD
• Mental Health Centers of Central Illinois

  dba Memorial Behavioral Health Counseling Associates

  • Clinical Social Worker
  • Springfield, IL
  • NPI 1750614798
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1891282760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N 8TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N 1ST ST STE 225",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627023760",
            "telephone_number": "217-788-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "JESSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149020119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruchi Gupta, M.D.
• Zachariah Gurnsey, MD
• Carolyn Gurski
• Terri Eileen Gustafson, P.T.
• Jason Paul Guthrie, M.D
• Amber Guyton
• Sandesh Gyawali, MBBS
• Alison Lynne Haacke, APRN
• Alissa Haas, MD
• Constance A Habenschuss, APN

• Clinical Social Worker in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.

Verify at the official NPI Registry.