Michael David Engelbert-fenton, PA-C is a medicare enrolled "Physician Assistant - Medical" physician in Salt Lake City, Utah. His current practice location is
150 S 1000 E, Salt Lake City, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 363-4071.
Michael David Engelbert-fenton is licensed to practice in Utah (license number 102950-1206) 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 1194701920.
Physician's Profile
Full Name | Michael David Engelbert-fenton |
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Gender | Male |
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Speciality | Physician Assistant - Medical |
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Location | 150 S 1000 E, Salt Lake City, Utah |
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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: 1194701920
- Provider Enumeration Date: 12/22/2005
- Last Update Date: 09/14/2021
Medicare PECOS Information:
- PECOS PAC ID: 8729144357
- Enrollment ID: I20090306000310
Medical Identifiers
Medical identifiers for Michael David Engelbert-fenton such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1194701920 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 102950-1206 (Utah) | Secondary |
363AM0700X | Physician Assistant - Medical | 102950-1206 (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. Michael David Engelbert-fenton 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 |
Michael David Engelbert-fenton, PA-C 6275 Snowview Dr, Park City, UT 84098-6118 Ph: (435) 645-7852 | Michael David Engelbert-fenton, PA-C 150 S 1000 E, Salt Lake City, UT 84102-1443 Ph: (801) 363-4071 |
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