Active NPI
Alyssa M. Eckert, MD
- Student in an Organized Health Care Education/Training Program
- Salt Lake City, UT
National Provider Identifier
1447838214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125 - Phone
- (801) 662-5700
- NPI assigned
- Mar 31, 2021
- Last updated
- Jun 6, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MD | Primary | |
| Pediatrics Physician | 208000000X | 12994414-1205 | UT |
Addresses
Primary practice location
81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Mailing address
6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6423
Other practice location 1
600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 955-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220907003448 | UT | Order and Referring Only - Pediatric Medicine | 3779967963 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12994414-1205 | UT | MD | Pediatrics Physician |
Interoperability endpoints
- aeckert1239298@direct.hopkinsmedicine.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1447838214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6201 GREENLEIGH AVE",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212202004",
"telephone_number": "410-933-6423",
"fax_number": "410-500-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131125",
"telephone_number": "801-662-5700"
}
],
"practiceLocations": [
{
"address_1": "600 N Wolfe St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212870005",
"country_code": "US",
"telephone_number": "410-955-5000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ECKERT",
"first_name": "ALYSSA",
"middle_name": "M.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-31",
"last_updated": "2024-06-06",
"certification_date": "2024-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MD",
"license": null,
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "12994414-1205",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.