Individual provider Active NPI

Megan Y Munnich

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1306683693
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029720 Issued in CA
Practice address
222 S Main St Ste 500
Salt Lake City, UT 84101-2275
Phone
(385) 258-2751
NPI assigned
Jul 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95029720 CA Primary

Addresses

Primary practice location

222 S Main St Ste 500
Salt Lake City, UT 84101-2275

Mailing address

222 S Main St Ste 500
Salt Lake City, UT 84101-2275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807003095 CA Practitioner - Nurse Practitioner 2365989373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Saginaw Valley Medical College - NLG, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Post Acute Rehabilitation Physicians LLCGroup PAC ID 7214334614, 44 clinicians

Practice addresses (Care Compare)

San Ramon, CA 94583
Phone (801) 215-9309

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Rehabilitation Physicians LLC CurrentSince Jul 12, 2024 Accepting new patients

Locations

20090 Stanton Ave
Castro Valley, CA 94546
Phone (510) 538-8464

5201 Norris Canyon Rd
Ste 220
San Ramon, CA 94583
Phone (925) 277-1900

5201 Norris Canyon Rd
San Ramon, CA 94583
Phone (206) 426-2584

11120 NE 33rd Pl
Ste 202
Bellevue, WA 98004
Phone (206) 426-2584

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1306683693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S MAIN ST STE 500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841012275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S MAIN ST STE 500",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841012275",
            "telephone_number": "385-258-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNNICH",
        "first_name": "MEGAN",
        "middle_name": "Y",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.