Theresa Ann Hennessey, MD in Salt Lake City, UT

Theresa Ann Hennessey, MD is a medicare enrolled "Orthopaedic Surgery - Pediatric Orthopaedic Surgery" physician in Salt Lake City, Utah. Her current practice location is Shriners Hospitals For Children, Fairfax Road At Virginia Street, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 536-3600.

Theresa Ann Hennessey is licensed to practice in Utah (license number 5897436-1205) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699826693.

Contact Information

	Theresa Ann Hennessey, MD
	Shriners Hospitals For Children, Fairfax Road At Virginia Street, Salt Lake City, UT 84103-4399
	(801) 536-3600
	(801) 536-3868

Map and Direction

Physician's Profile

Full Name	Theresa Ann Hennessey
Gender	Female
Speciality	Orthopaedic Surgery - Pediatric Orthopaedic Surgery
Location	Shriners Hospitals For Children, 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: 1699826693
Provider Enumeration Date: 01/16/2007
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 9234283011
Enrollment ID: I20090812000896

Medical Identifiers

Medical identifiers for Theresa Ann Hennessey such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1699826693	NPI	-	NPPES
5897436-8905	Other	UT	CONTROLLED SUBSTANCE LIC
5897436-1205	Other	UT	STATE LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207XP3100X	Orthopaedic Surgery - Pediatric Orthopaedic Surgery	5897436-1205 (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. Theresa Ann Hennessey allows following entities to bill medicare on her behalf.

Entity Name	Shriners Hospitals For Children
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396187282 PECOS PAC ID: 9133031933 Enrollment ID: O20140703000851

Entity Name	University Of Utah Adult Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114321981 PECOS PAC ID: 0941525273 Enrollment ID: O20150209001683

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

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. Theresa Ann Hennessey 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
Theresa Ann Hennessey, MD Shriners Hospitals For Children Salt, Dept 5034, Los Angeles, CA 90084-0001 Ph: (813) 281-8478	Theresa Ann Hennessey, MD Shriners Hospitals For Children, Fairfax Road At Virginia Street, Salt Lake City, UT 84103-4399 Ph: (801) 536-3600

Reviews and Comments

Orthopaedic Surgery Doctors in Salt Lake City, UT

Cameron R. Guy, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 590 S Wakara Way Rm A0058, Salt Lake City, UT 84108 Phone: 801-581-2121
Benjamin Williams, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 82 S 1100 E Ste 303, Salt Lake City, UT 84102 Phone: 801-533-2002 Fax: 801-323-9546
Chrystina James, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 590 S Wakara Way Rm A0058, Salt Lake City, UT 84108 Phone: 801-581-2121
Thomas D. Bauman, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 333 S 900 E, Salt Lake City, UT 84102 Phone: 801-535-8163 Fax: 801-355-4011
Jaclyn Aleksandra Konopka, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 590 S Wakara Way Rm A0058, Salt Lake City, UT 84108 Phone: 801-581-2121
Kayla L. Gates, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 590 S Wakara Way, Salt Lake City, UT 84108 Phone: 801-587-5448
Jeffrey D Jackson, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 1160 E 3900 S Ste 5000, Salt Lake City, UT 84124 Phone: 801-261-7479 Fax: 801-261-7429

Theresa Ann Hennessey, MD - Medicare Orthopaedic Surgery in Salt Lake City, UT