Individual provider Active NPI

Sierra Rose Mayzsak, APRN

  • Family Nurse Practitioner
  • Ogden, UT
National Provider Identifier
1073237624
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10086344-4405 Issued in UT
Practice address
1525 E 6000 S
Ogden, UT 84405-7144
Phone
(801) 337-5800
NPI assigned
Sep 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10086344-4405 UT Primary

Addresses

Primary practice location

1525 E 6000 S
Ogden, UT 84405-7144

Mailing address

1525 E 6000 S
Ogden, UT 84405-7144
Phone (801) 337-5800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230120001900 UT Practitioner - Nurse Practitioner 8325419872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Circle of Life IncGroup PAC ID 5193703544, 10 clinicians

Practice addresses (Care Compare)

1525 E 6000
Suite a
Ogden, UT 84405-7149
Phone (801) 337-5800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Circle of Life Inc CurrentSince Jan 1, 2023 Accepting new patients

Locations

1525 E 6000 S
South Ogden, UT 84405
Phone (801) 337-5800

1525 E 6000 S
Ste A
South Ogden, UT 84405
Phone (801) 337-5800

Interoperability endpoints

  • Direct secure messaging: mindfulmedical.sierramayzsak@156096.advancedmd-direct.com

Organizations & group practices 1

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": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1073237624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E 6000 S",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844057144",
            "telephone_number": "801-337-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 6000 S",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844057144",
            "telephone_number": "801-337-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYZSAK",
        "first_name": "SIERRA",
        "middle_name": "ROSE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10086344-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.