Mariya Nikolaeva, is a
Physician Assistant physician based in Salt Lake City, Utah. Mariya Nikolaeva is licensed to practice in Utah (license number 12492182-1206) and her current practice location is 1685 W 2200 S, Salt Lake City, Utah. She can be reached at her office (for appointments etc.) via phone at
(801) 478-7705.
NPI number for Mariya Nikolaeva is 1124675079 and her current mailing address is Po Box 27128, Salt Lake City, Utah. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1124675079.
Physician's Profile
| Full Name | Mariya Nikolaeva |
|---|
| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 1685 W 2200 S, Salt Lake City, Utah |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1124675079
- Provider Enumeration Date: 08/23/2019
- Last Update Date: 05/25/2022
Medical Identifiers
Medical identifiers for Mariya Nikolaeva such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124675079 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 12492182-1206 (Utah) | Secondary |
| 363A00000X | Physician Assistant | 12492182-1206 (Utah) | Primary |
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. Mariya Nikolaeva is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mariya Nikolaeva,
Po Box 27128,
Salt Lake City, UT 84127-0128
Ph: () - | Mariya Nikolaeva,
1685 W 2200 S,
Salt Lake City, UT 84119-1456
Ph: (801) 478-7705 |
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