Individual provider Active NPI

Anastasiya Mankouski, MD

  • Neonatal-Perinatal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1003366766
Registry record updated Nov 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
10102332-1205 Issued in UT
Practice address
5121 S Cottonwood St
Salt Lake City, UT 84107-5701
Phone
(801) 507-7000
NPI assigned
Oct 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 10102332-1205 UT Primary

Addresses

Primary practice location

5121 S Cottonwood St
Salt Lake City, UT 84107-5701

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (201) 527-5501

Other names 1

  • Anastasiya Chystsiakova Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amankouski231096@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20161222001132 UT Practitioner - Pediatric Medicine 6002197498 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Acuity Care Services CurrentSince Jan 1, 2017 Accepting new patients
University of Utah Acuity Care Services CurrentSince Jan 1, 2017 Accepting new patients
Ihc Health Services Inc CurrentSince Nov 1, 2016 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
University of Utah Acuity Care Services Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 1, 2016 Accepting new patients
University of Utah Pediatric Acuity Care Neonatal-Perinatal Medicine Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

454 E Medical Way
Heber City, UT 84032
Phone (435) 654-2500

2250 N Miller Campus Dr
Lehi, UT 84048
Phone (385) 531-1000

900 Round Valley Dr
Park City, UT 84060
Phone (435) 658-7000

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

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

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Interoperability endpoints

  • Direct secure messaging: amankouski231096@direct.med.utah.edu

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637366400000",
    "number": "1003366766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "201-527-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-507-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKOUSKI",
        "first_name": "ANASTASIYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2021-11-20",
        "certification_date": "2021-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "UT",
            "license": "10102332-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amankouski231096@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANASTASIYA",
            "last_name": "CHYSTSIAKOVA",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.