| Scenic Way Llc | |
|
4252 S Birkhill Blvd Murray UT 84107-5715 | |
| (385) 425-0050 | |
| (801) 296-1715 |
| Full Name | Scenic Way Llc |
|---|---|
| Speciality | Hospitalist |
| Location | 4252 S Birkhill Blvd, Murray, Utah |
| Authorized Official Name and Position | Kirsten Novak (OWNER) |
| Authorized Official Contact | 8019512351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Scenic Way Llc Po Box 1249 Bountiful UT 84011-1249 Ph: () - | Scenic Way Llc 4252 S Birkhill Blvd Murray UT 84107-5715 Ph: (385) 425-0050 |
| NPI Number | 1952175127 |
|---|---|
| Provider Enumeration Date | 11/08/2023 |
| Last Update Date | 06/24/2024 |
| Medicare PECOS PAC ID | 1355786765 |
|---|---|
| Medicare Enrollment ID | O20240226000989 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952175127 | NPI | - | NPPES |
| Provider Name | Mark L Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508861964 PECOS PAC ID: 7911942909 Enrollment ID: I20050621000457 |
| Provider Name | William Tettelbach |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1336143361 PECOS PAC ID: 1254368194 Enrollment ID: I20051015000078 |
| Provider Name | Michael Sebastian Galindo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861417057 PECOS PAC ID: 1355386749 Enrollment ID: I20100925000079 |
| Provider Name | Sikandar Ansari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740470731 PECOS PAC ID: 0749422913 Enrollment ID: I20151106001373 |
| Provider Name | Trevor D Morrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609238138 PECOS PAC ID: 9739477431 Enrollment ID: I20161012002619 |
| Provider Name | Kirsten Leah Novak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336175967 PECOS PAC ID: 0042523573 Enrollment ID: I20170728003289 |
| Provider Name | Daniel Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356950554 PECOS PAC ID: 0941626881 Enrollment ID: I20200821002227 |
| Provider Name | Keila Rae Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396464277 PECOS PAC ID: 6305292137 Enrollment ID: I20231030003135 |
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