NPIMap

Individual provider Active NPI

Kaitlyn Hayes Pelletier, APRN

  • Gerontology Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1194345603
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
8382143-4405 Issued in UT
Practice address
2000 Circle of Hope Dr # 1950
Salt Lake City, UT 84112-5550
Phone
(225) 278-9303
NPI assigned
Apr 24, 2020
Last updated
Nov 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 8382143-4405 UT Primary

Addresses

Primary practice location

2000 Circle of Hope Dr # 1950
Salt Lake City, UT 84112-5550

Mailing address

1926 E Parkridge Dr
Salt Lake City, UT 84121-4857

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address khayes88866@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200619001841 UT Practitioner - Nurse Practitioner 8527480508 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians
Wasatch NP House Calls LLCGroup PAC ID 7911435888, 2 clinicians

Practice addresses (Care Compare)

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-8793

3907 Silver Spur Cir
Park City, UT 84098-4819
Phone (801) 252-5209

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8382143-4405UTMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince May 15, 2020 Accepting new patients
University of Utah Adult Services CurrentSince May 15, 2020 Accepting new patients
Wasatch NP House Calls LLC CurrentSince Jan 1, 2025 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients

Locations

50 W Broadway
Ste 333
Salt Lake Cty, UT 84101
Phone (321) 458-5663

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

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

Interoperability endpoints

  • Direct secure messaging: kaitlyn.pelletier@906892991594500.direct.elationemr.com

Organizations & group practices 5

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

Hospital & facility affiliations 8

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": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1194345603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 E PARKRIDGE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841214857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CIRCLE OF HOPE DR # 1950",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125550",
            "telephone_number": "225-278-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "KAITLYN",
        "middle_name": "HAYES",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "UT",
            "license": "8382143-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "khayes88866@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": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.