Individual provider Active NPI

Lisa Marie Saturnino, MD

  • Family Medicine Physician
  • Park City, UT
National Provider Identifier
1336362490
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4956314-1205 Issued in MI
Practice address
1665 Bonanza Dr.
Park City, UT 84060-5127
Phone
(435) 649-7640
Fax
(435) 645-7668
NPI assigned
Apr 10, 2007
Last updated
Aug 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4956314-1205 MI Primary

Addresses

Primary practice location

1665 Bonanza Dr.
Park City, UT 84060-5127

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 491-6482

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
I20040427000882 UT Practitioner - Family Practice 5799772356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

3850 Canyons Resort Dr
Park City, UT 84098-6546
Phone (435) 615-2235

4000 Canyons Resort Dr
Park City, UT 84098-6546
Phone (435) 615-2235

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4956314-1205MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jan 20, 2004 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc CurrentSince Aug 1, 2012 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 20, 2004 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1975 N State St
Orem, UT 84057
Phone (801) 714-5000

1665 Bonanza Dr
Park City, UT 84060
Phone (435) 649-7640

750 Round Valley Dr
Ste 201
Park City, UT 84060
Phone (435) 649-7640

900 Round Valley Dr
Park City, UT 84060
Phone (435) 658-7000

900 Round Valley Dr
Ste 200
Park City, UT 84060
Phone (435) 658-7246

762 W 400 S
Springville, UT 84663
Phone (801) 429-1200

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Organizations & group practices 6

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 1

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1336362490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-491-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 BONANZA DR.",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840605127",
            "telephone_number": "435-649-7640",
            "fax_number": "435-645-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATURNINO",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4956314-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

Verify at the official NPI Registry.