Individual provider Active NPI

Sarah Jane Ilstrup, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Salt Lake City, UT
National Provider Identifier
1104895598
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
316585-1205 Issued in UT
Practice address
8TH Avenue & C Street
Salt Lake City, UT 84143-0001
Phone
(801) 408-2285
Fax
(801) 408-5196
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 316585-1205 UT Primary

Addresses

Primary practice location

8TH Avenue & C Street
Salt Lake City, UT 84143-0001

Mailing address

PO Box 30309
Charleston, SC 29417-0309
Phone (843) 554-9300

Other identifiers 1

IdentifierTypeStateIssuer
870326048001D4805MedicaidUT

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
I20040630000876 UT Practitioner - Pathology 8729065594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Minnesota Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Pathology Services IncGroup PAC ID 1355251521, 28 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-7850

1400 N 500
Logan, UT 84341-2455
Phone (435) 716-1000

3741 W 12600
Riverton, UT 84065-7215
Phone (801) 266-0055

5252 S Intermountain Dr
Murray, UT 84107-5700
Phone (801) 266-0055

8 TH Ave and C St
Salt Lake City, UT 84143-0001
Phone (801) 266-0055

900 Round Valley Dr
Park City, UT 84060-7552
Phone (801) 266-0055

Hospital & facility affiliations

  • St. George Regional Hospital Hospital, St George, UT, CCN 460021
  • Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044
  • Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058
  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010

Merit-based Incentive Payment System (MIPS)

Final score
88.42 of 100Reported as group
Quality
86.38
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
316585-1205UTMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Pathology Services, Inc Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2003 Accepting new patients

Locations

5700 Southwyck Blvd
Toledo, OH 43614

5330 S 900 E
Ste 120
Murray, UT 84117
Phone (801) 631-8769

8th Ave C St
Salt Lake City, UT 84143
Phone (801) 269-2500

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

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.

Hospital & facility affiliations 5

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1104895598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30309",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294170309",
            "telephone_number": "843-554-9300",
            "fax_number": "843-566-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8TH AVENUE & C STREET",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841430001",
            "telephone_number": "801-408-2285",
            "fax_number": "801-408-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILSTRUP",
        "first_name": "SARAH",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "UT",
            "license": "316585-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870326048001D4805",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.