Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Usha Gautam, NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1508665605

Usha Gautam, NURSEPRACTITIONER is a Nurse Practitioner in Sandy, Utah. Qualified in 2024, 2 years ago. Practices with Santibanez PAC Utah, a 24-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
2
Licensed in
UT
In the registry since
2025

Practice location Address checks out

243 E Hammermill Ln
Sandy, UT 84070-2918
Phone: (385) 234-8696
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 11176038-4405 (UT)

Record details

NPI number1508665605
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedMarch 11, 2025
Last updated in NPPESMarch 11, 2025
Certification dateMarch 11, 2025
Mailing address243 E Hammermill Ln, Sandy, UT 84070-2918

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Santibanez Pac Utah — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Sandy