Individual provider Active NPI

Melissa J Bentley, M.D.

  • Internal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1639354897
Registry record updated Jul 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6826224-1205 Issued in UT
Practice address
660 S 200 E Ste 250
Salt Lake City, UT 84111-3846
Phone
(801) 359-2256
Fax
(801) 364-4392
NPI assigned
Jan 7, 2008
Last updated
Jul 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 6826224 -1205 UT
Internal Medicine Physician 207R00000X 6826224-1205 UT Primary

Addresses

Primary practice location

660 S 200 E Ste 250
Salt Lake City, UT 84111-3846

Mailing address

660 S 200 E Ste 250
Salt Lake City, UT 84111-3846
Phone (801) 359-2256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20181011000143 TX Practitioner - Family PracticePractitioner - Internal Medicine 2961556261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Utah School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

660 S 200
Suite 250
Salt Lake City, UT 84111-3846

660 S 200 E
Salt Lake, UT 84111-3846
Phone (801) 395-2256

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6826224 -1205UTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Confederated Tribes of the Goshute Reservation CurrentSince Jul 28, 2018 Accepting new patients
Confederated Tribes of the Goshute Reservation Past Accepting new patients

Locations

195 Tribal Center Rd
Ibapah, UT 84034
Phone (435) 234-1302

660 S 200 E
Ste 250
Slc, UT 84111
Phone (801) 395-2256

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657411200000",
    "number": "1639354897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S 200 E STE 250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113846",
            "telephone_number": "801-359-2256",
            "fax_number": "801-364-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S 200 E STE 250",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841113846",
            "telephone_number": "801-359-2256",
            "fax_number": "801-364-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTLEY",
        "first_name": "MELISSA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "6826224 -1205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "6826224-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.