NPIMap

Individual provider Active NPI

Shonti G. Breisch, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1447725247
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11439425-1206 Issued in UT
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-1947
Phone
(801) 581-7606
NPI assigned
Oct 8, 2018
Last updated
Oct 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11439425-1206 UT Primary

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-1947

Mailing address

6150 S Vineway Cir
Murray, UT 84121-1947
Phone (801) 243-8165

Other practice location 1

6150 S Vineway Cir
Murray, UT 84121-1947
Phone (801) 243-8165

Other practice location 2

3580 W 9000 S
West Jordan, UT 84088-8812
Phone (801) 561-8888

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SBREISCH600534@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
I20191002002175 UT Practitioner - Physician Assistant 9032449152 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tooele Clinic CorpGroup PAC ID 6800700873, 63 clinicians
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

2055 N Main St
Tooele, UT 84074-9819
Phone (435) 943-3600

2321 N 400
Suite 300
Tooele, UT 84074-3440
Phone (435) 833-9180

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

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

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as group
Quality
91.38
Promoting interoperability
100
Improvement activities
40
Cost
77.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Aug 15, 2022 Accepting new patients
University of Utah Adult Services CurrentSince Aug 15, 2022 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Aug 29, 2019 Accepting new patients

Locations

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

2055 N Main St
Tooele, UT 84074
Phone (435) 843-3600

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 562-4210

Interoperability endpoints

  • Direct secure messaging: sbreisch@yourcarecommunity.org
  • Direct secure messaging: sbreisch600534@direct.med.utah.edu

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 5

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": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1447725247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 S VINEWAY CIR",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841211947",
            "telephone_number": "801-243-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841321947",
            "telephone_number": "801-581-7606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6150 S Vineway Cir",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841211947",
            "country_code": "US",
            "telephone_number": "801-243-8165",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3580 W 9000 S",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840888812",
            "country_code": "US",
            "telephone_number": "801-561-8888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREISCH",
        "first_name": "SHONTI",
        "middle_name": "G.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11439425-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SBREISCH600534@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": "841321947",
            "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.