Individual provider Active NPI

Brooke Mastroianni, M.D.

  • Child & Adolescent Psychiatry Physician
  • Sandy, UT
National Provider Identifier
1003347923
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
13477083-1205 Issued in UT
Practice address
9450 S 1300 E
Sandy, UT 84094-5555
Phone
(801) 501-2131
NPI assigned
Mar 22, 2017
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 6984420 WI
Child & Adolescent Psychiatry Physician 2084P0804X 0101273885 VA
Child & Adolescent Psychiatry Physician 2084P0804X 13477083-1205 UT Primary

Addresses

Primary practice location

9450 S 1300 E
Sandy, UT 84094-5555

Mailing address

9450 S 1300 E
Sandy, UT 84094-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, UT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220805001285 VA Practitioner - Psychiatry 6709122096 Reassigns benefits to 1 organization
I20230929001088 UT Practitioner - Psychiatry 6709122096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

675 E 500
PCH Neuropsychology
Salt Lake City, UT 84102-2818
Phone (801) 662-5592

9450 S 1300
FL 4
Sandy, UT 84094-5555
Phone (801) 507-3500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6984420WIMDPsychiatry Physician
13477083-1205UTMDChild & Adolescent Psychiatry Physician
0101273885VAMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. Psychiatry CurrentSince Oct 1, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 1, 2023 Accepting new patients
Childrens Specialty Group PLLC CurrentSince Jul 1, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Mar 1, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

12473 S Minuteman Dr
Draper, UT 84020
Phone (801) 495-7900

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1225 E Fort Union Blvd
Ste 315
Midvale, UT 84047
Phone (801) 233-4100

3723 W 12600 S
Ste 330
Riverton, UT 84065
Phone (801) 285-4543

5541 W 13400 S
Riverton, UT 84096
Phone (801) 871-4700

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

9450 S 1300 E
Sandy, UT 84094
Phone (801) 501-2133

9450 S 1300 E
Fl 4
Sandy, UT 84094
Phone (801) 501-2145

955 E 11400 S
Sandy, UT 84094
Phone (801) 571-0030

389 S 900 E
Slc, UT 84102
Phone (385) 282-2000

5770 S 1500 W
Bldg C
Taylorsville, UT 84123
Phone (801) 265-3049

3845 W 4700 S
West Valley City, UT 84129
Phone (801) 840-2020

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

850 Southampton Ave
Norfolk, VA 23510
Phone (757) 668-4673

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1003347923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9450 S 1300 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840945555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 S 1300 E",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840945555",
            "telephone_number": "801-501-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTROIANNI",
        "first_name": "BROOKE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "6984420",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VA",
            "license": "0101273885",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "UT",
            "license": "13477083-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

Verify at the official NPI Registry.