Mandi Sarita Vlam, APRN

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

8752008-4405 Issued in UT

Practice address

168 N 1950 W Ste 201
Salt Lake City, UT 84116-3007

Phone

(801) 213-2537

NPI assigned

Apr 11, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Utah School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amazing Medical Associates IncGroup PAC ID 5991606329, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Amazing Medical Associates, Inc

  dba AMG Senior Medical Group

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1487836532
  Medicare reassignment Care Compare group NPD
• University of Utah Community Physicians Group

  dba UUHC - Redstone Center

  • Family Medicine Physician
  • Park City, UT
  • NPI 1053715763
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Regional Medical Center

  dba Air St Luke's

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1396598975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 N 1950 W STE 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 N 1950 W STE 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841163007",
            "telephone_number": "801-213-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLAM",
        "first_name": "MANDI",
        "middle_name": "SARITA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8752008-8900",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "UT",
            "license": "8752008-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John S Vitkus, PHD
• Janet Vivian, C.S.W.
• Vivid Safe House
• Richard Vlach
• Sarah Vlach, SUDC
• Kajsa E. Vlasic, MD
• Monika Vloka, MD
• Kuang-Yie Vo, PHARMD
• Michelle Vo, M.D.
• Rebecca Voaklander

• Gerontology Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Gerontology Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.