Dr Kristina Irene Suorsa-johnson, PHD in Salt Lake City, UT

Dr Kristina Irene Suorsa-johnson, PHD is a medicare enrolled "Psychologist - Clinical" provider in Salt Lake City, Utah. Her current practice location is 81 N Mario Capecchi Dr, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 662-1000.

Dr Kristina Irene Suorsa-johnson is licensed to practice in Utah (license number 12196719-2501) 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 1205509429.

Contact Information

	Dr Kristina Irene Suorsa-johnson, PHD
	81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125
	(801) 662-1000
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Kristina Irene Suorsa-johnson
Gender	Female
Speciality	Psychologist - Clinical
Location	81 N Mario Capecchi Dr, 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: 1205509429
Provider Enumeration Date: 07/26/2021
Last Update Date: 12/20/2021

Medicare PECOS Information:

PECOS PAC ID: 2264821396
Enrollment ID: I20211111001383

Medical Identifiers

Medical identifiers for Dr Kristina Irene Suorsa-johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205509429	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	12196719-2501 (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. Dr Kristina Irene Suorsa-johnson allows following entities to bill medicare on her behalf.

Entity Name	Ihc Health Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079

Entity Name	University Of Utah Pediatric Behavioral Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649631599 PECOS PAC ID: 3870886898 Enrollment ID: O20160727002309

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. Dr Kristina Irene Suorsa-johnson 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
Dr Kristina Irene Suorsa-johnson, PHD 815 E Rowley Dr, Millcreek, UT 84107-3028 Ph: (401) 864-5906	Dr Kristina Irene Suorsa-johnson, PHD 81 N Mario Capecchi Dr, Salt Lake City, UT 84113-1125 Ph: (801) 662-1000

Reviews and Comments

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Dr Kristina Irene Suorsa-johnson, PHD - Medicare Psychologist in Salt Lake City, UT