Douglas M. Sirutis, MD, MPH, MS

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

14164811-1205 Issued in UT

Practice address

501 S Chipeta Way
Salt Lake City, UT 84108-1222

Phone

(801) 581-7951

Fax

(801) 581-5604

NPI assigned

Mar 27, 2023

Last updated

Sep 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

Practice roles

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.

• Moonlit

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1275348807
  NPD (past)

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1255035077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081222",
            "telephone_number": "801-581-7951",
            "fax_number": "801-581-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081222",
            "telephone_number": "801-581-7951",
            "fax_number": "801-581-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRUTIS",
        "first_name": "DOUGLAS",
        "middle_name": "M.",
        "credential": "MD, MPH, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "14164811-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Cade Sink, PA-C
• Chelsey Marie Sio
• Lorraine Sippel
• Lynn M. Sipsey, MD, MBE
• Janet H. Sirstins, RN
• Joseph Ray Sisneros
• Kevin Sisneros
• Michael Sistrunk
• Pamrose Sitake
• Karishma Sitapara, DDS

• Psychiatry Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Psychiatry Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.