Brian J Moench, MD | |
400 C St, Salt Lake City, UT 84143-1005 | |
(801) 993-9582 | |
(801) 733-5618 |
Full Name | Brian J Moench |
---|---|
Gender | Male |
Speciality | Anesthesiology |
Location | 400 C St, Salt Lake City, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801805767 | NPI | - | NPPES |
TPRA07309 | Other | UT | MOLINA |
20835 | Other | UT | DESERET MUTUAL |
107005585102 | Other | UT | IHC |
1502954 | Other | UT | UMWA |
66119 | Other | UT | PEHP |
QM0000075886 | Other | UT | ALTIUS |
702 | Other | UT | HEALTHY U |
820309 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 166534-1205 (Utah) | Primary |
Entity Name | Mountain West Anesthesia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558391763 PECOS PAC ID: 9032018502 Enrollment ID: O20040103000057 |
Mailing Address | Practice Location Address |
---|---|
Brian J Moench, MD 2975 Executive Pkwy, 200, Lehi, UT 84043-9642 Ph: (801) 990-1911 | Brian J Moench, MD 400 C St, Salt Lake City, UT 84143-1005 Ph: (801) 993-9582 |
Dr. Anne Wierman Estares, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 30 N 1900 E, Rm 4c104, Salt Lake City, UT 84132 Phone: 719-314-5254 | |
Ashley Nicole Langell, MS, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 30 N 1900 E Rm 3c444, Salt Lake City, UT 84132 Phone: 801-581-3622 | |
Dr. Nicole Jeffreys, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 100 Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-3578 | |
Matthew L Peterson, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1200 E 3900 S, Salt Lake City, UT 84124 Phone: 801-993-9530 Fax: 801-733-5618 | |
Dr. Jeffrey David Dillon, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 30 N 1900 E, Room 3c444, Salt Lake City, UT 84132 Phone: 801-581-6393 Fax: 801-581-4367 | |
Jennifer Jean Davis, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-581-6393 | |
Dennis L. Morris, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1200 E 3900 S, Salt Lake City, UT 84124 Phone: 801-993-9530 Fax: 801-733-5618 |