- in Sandy, UT

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is a Internal Medicine based in Sandy, Utah. is licensed to practice in Utah (license number 55767) and their current practice location is 9500 S 1300 E, Sandy, Utah. It can be reached at their office (for appointments etc.) via phone at (801) 501-2100.

NPI number for is 1164558847 and their current mailing address is Po Box 27128, Salt Lake City, Utah. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1164558847.

Contact Information

9500 S 1300 E,
Sandy, UT 84094-3763
(801) 501-2100
Not Available

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityInternal Medicine
Location9500 S 1300 E, Sandy, Utah
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1164558847
  • Provider Enumeration Date: 02/26/2007
  • Last Update Date: 07/31/2008

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164558847NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 55767 (Utah)Secondary
207K00000XAllergy & Immunology 55767 (Utah)Secondary
207N00000XDermatology 55767 (Utah)Secondary
207R00000XInternal Medicine 55767 (Utah)Primary
207RG0100XInternal Medicine - Gastroenterology 55767 (* (Not Available))Secondary
207RP1001XInternal Medicine - Pulmonary Disease 55767 (Utah)Secondary
207W00000XOphthalmology 55767 (* (Not Available))Secondary
208000000XPediatrics 55767 (Utah)Secondary
208200000XPlastic Surgery 55767 (Utah)Secondary
208600000XSurgery 55767 (Utah)Secondary

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. 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 AddressPractice Location Address

Po Box 27128,
Salt Lake City, UT 84127-0128

Ph: (801) 501-2100
9500 S 1300 E,
Sandy, UT 84094-3763

Ph: (801) 501-2100

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.