Charles W Pruitt, MD in Salt Lake City, UT

Charles W Pruitt, MD is a medicare enrolled "Pediatrics - Pediatric Emergency Medicine" physician in Salt Lake City, Utah. His current practice location is 100 N Medical Dr, Salt Lake City, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 662-1000.

Charles W Pruitt is licensed to practice in Utah (license number 6079976-1205) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1962583757.

Contact Information

	Charles W Pruitt, MD
	100 N Medical Dr, Salt Lake City, UT 84113-1103
	(801) 662-1000
	Not Available

Map and Direction

Physician's Profile

Full Name	Charles W Pruitt
Gender	Male
Speciality	Pediatrics - Pediatric Emergency Medicine
Location	100 N Medical Dr, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962583757
Provider Enumeration Date: 10/18/2006
Last Update Date: 12/01/2021

Medicare PECOS Information:

PECOS PAC ID: 6901812692
Enrollment ID: I20060306000182

Medical Identifiers

Medical identifiers for Charles W Pruitt such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962583757	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2080P0204X	Pediatrics - Pediatric Emergency Medicine	6079976-1205 (Utah)	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. Charles W Pruitt allows following entities to bill medicare on his behalf.

Entity Name	University Of Utah Pediatric Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487018974 PECOS PAC ID: 0547552473 Enrollment ID: O20160713000371

Entity Name	University Of Utah Pediatric Acuity Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1619325131 PECOS PAC ID: 6406148345 Enrollment ID: O20160713000869

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. Charles W Pruitt 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
Charles W Pruitt, MD Po Box 581100, Salt Lake City, UT 84158-1100 Ph: (801) 213-3800	Charles W Pruitt, MD 100 N Medical Dr, Salt Lake City, UT 84113-1103 Ph: (801) 662-1000

Reviews and Comments

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Kristina Mckinley, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: University Of Utah Hospital, 30 North 1900 East, Rm 1c412, Salt Lake City, UT 84132 Phone: 801-581-2401
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George W Delavan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 44 N Mario Capecchi Dr, Salt Lake City, UT 84132 Phone: 801-584-8239 Fax: 801-584-8588
Michelle Ploutz, Pediatrics Medicare: Medicare Enrolled Practice Location: 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-1000 Fax: 018-213-7778

Charles W Pruitt, MD - Medicare Pediatrics in Salt Lake City, UT