Mrs Mercedes Longshaw Mortensen, AGNP-C in Salt Lake City, UT

Mrs Mercedes Longshaw Mortensen, AGNP-C is a medicare enrolled "Nurse Practitioner - Adult Health" in Salt Lake City, Utah. Her current practice location is 522 E 100 S, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 485-5055.

Mrs Mercedes Longshaw Mortensen is licensed to practice in Utah (license number 283800-4405) 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 1811660764.

Contact Information

	Mrs Mercedes Longshaw Mortensen, AGNP-C
	522 E 100 S, Salt Lake City, UT 84102-1905
	(801) 485-5055
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Mercedes Longshaw Mortensen
Gender	Female
Speciality	Nurse Practitioner - Adult Health
Location	522 E 100 S, 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: 1811660764
Provider Enumeration Date: 07/27/2021
Last Update Date: 07/27/2021

Medicare PECOS Information:

PECOS PAC ID: 0547665440
Enrollment ID: I20210816001289

Medical Identifiers

Medical identifiers for Mrs Mercedes Longshaw Mortensen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811660764	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	283800-4405 (Utah)	Secondary
363LA2200X	Nurse Practitioner - Adult Health	283800-4405 (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. Mrs Mercedes Longshaw Mortensen allows following entities to bill medicare on her behalf.

Entity Name	Livi Medical Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457667750 PECOS PAC ID: 8820283039 Enrollment ID: O20211001001268

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. Mrs Mercedes Longshaw Mortensen 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
Mrs Mercedes Longshaw Mortensen, AGNP-C 3204 S Harmony Cir, Salt Lake City, UT 84109-2706 Ph: (925) 262-7059	Mrs Mercedes Longshaw Mortensen, AGNP-C 522 E 100 S, Salt Lake City, UT 84102-1905 Ph: (801) 485-5055

Reviews and Comments

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Mrs Mercedes Longshaw Mortensen, AGNP-C - Medicare Nurse Practitioner in Salt Lake City, UT