Eric Marvin Carl Monfrooy, PA
Individual provider Active NPI Physician Assistant · Layton, UT
NPI 1124593942 · NPPES record last updated Jun 17, 2020
Key facts
- NPI
- 1124593942
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 11684717-1206 (UT)
- Practice address
- 2121 N 1700 W
Layton, UT 84041-8803 - Phone
- (801) 773-4840
- Fax
- (801) 525-8151
- NPI assigned
- Oct 8, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tecs Utah PC
Canyonlands Community Health Care
Practice addresses (Care Compare)
350 E 300
American Fork, UT 84003-1717
Phone (801) 756-5293
E Hwy 160 to Rte 59
Chilchinbito Chapter House Complex
Chilchinbito, AZ 86033-1496
Phone (928) 697-8154
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200619001095 | UT | Practitioner - Physician Assistant | 1850713819 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tecs Utah PC | Current |
Accepting new patients | |
| Corner Canyon Counseling | Past |
Accepting new patients |
Locations
18312 Middlebelt Rd
Livonia, MI 48152
Phone (248) 426-9944
350 E 300 N
American Fork, UT 84003
Phone (385) 350-8500
523 N Main St
Bountiful, UT 84010
Phone (801) 951-1600
775 N 200 E
Brigham City, UT 84302
Phone (435) 723-7777
1100 N 400 E
Nephi, UT 84648
Phone (435) 623-1721
163 E 1000 N
Richfield, UT 84701
Phone (435) 896-8211
2472 S 300 E
South Salt Lake, UT 84115
Phone (801) 273-6402
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 11684717-1206 | UT | Yes |
Addresses
Primary practice location
2121 N 1700 W
Layton, UT 84041-8803
Mailing address
PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840
Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.