Individual provider Active NPI

Erica N. Woertz, MD, PHD

  • Ophthalmology Physician
  • Salt Lake City, UT
National Provider Identifier
1083364467
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
13525991-1205 Issued in UT
Practice address
65 N Mario Capecchi
Salt Lake City, UT 84132-0002
Phone
(801) 581-2121
NPI assigned
Mar 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 13525991-1205 UT Primary

Addresses

Primary practice location

65 N Mario Capecchi
Salt Lake City, UT 84132-0002

Mailing address

65 N Mario Capecchi
Salt Lake City, UT 84132-0002
Phone (801) 581-2121

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
I20230905002225 UT Order and Referring Only - OphthalmologyPractitioner - Ophthalmology 9830552132

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Medical College of Wisconsin, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1400 SW 5TH Ave
FL 5
Portland, OR 97201-5509

2220 E Murray Holladay Rd
Apt 82
Holladay, UT 84117-5302

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13525991-1205UTMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1083364467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N MARIO CAPECCHI",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 N MARIO CAPECCHI",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOERTZ",
        "first_name": "ERICA",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "13525991-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.