Jessica Marie Gutierrez, LCSW, CSAC, ICS is a medicare enrolled "Social Worker - Clinical" provider in Madison, Wisconsin. Her current practice location is
2101 Linden Ave Apt 2, Madison, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(608) 466-6560.
Jessica Marie Gutierrez is licensed to practice in Wisconsin (license number 7533-123) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003052572.
Healthcare Provider's Profile
Full Name | Jessica Marie Gutierrez |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 2101 Linden Ave Apt 2, Madison, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1003052572
- Provider Enumeration Date: 01/05/2009
- Last Update Date: 08/13/2024
Medicare PECOS Information:
- PECOS PAC ID: 5294124988
- Enrollment ID: I20211118001858
Medical Identifiers
Medical identifiers for Jessica Marie Gutierrez such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1003052572 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 15584-132 (Wisconsin) | Secondary |
1041C0700X | Social Worker - Clinical | 7533-123 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica Marie Gutierrez allows following entities to bill medicare on her behalf.
Entity Name | University Of Wisconsin Medical Foundation Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1598784555 PECOS PAC ID: 6608785464 Enrollment ID: O20031111000435 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Marie Gutierrez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jessica Marie Gutierrez, LCSW, CSAC, ICS 2101 Linden Ave Apt 2, Madison, WI 53704-5350 Ph: (608) 466-6560 | Jessica Marie Gutierrez, LCSW, CSAC, ICS 2101 Linden Ave Apt 2, Madison, WI 53704-5350 Ph: (608) 466-6560 |
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