Individual provider Active NPI

Megan Prouty, MD

  • Dermatology Physician
  • Salt Lake City, UT
National Provider Identifier
1649633678
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
12222522-1205 Issued in UT
Practice address
1280 E Stringham Ave
Salt Lake City, UT 84106-2490
Phone
(801) 581-2955
NPI assigned
Mar 29, 2016
Last updated
Mar 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 940915 KS
Dermatology Physician 207N00000X 12222522-1205 UT Primary

Addresses

Primary practice location

1280 E Stringham Ave
Salt Lake City, UT 84106-2490

Mailing address

PO Box 841052
Los Angeles, CA 90084-1052
Phone (801) 581-2955

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mprouty515890@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: 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
I20210407002881 UT Practitioner - Dermatology 9638463250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Oklahoma College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dermatology Division University of Utah Medical CenterGroup PAC ID 9638073497, 73 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 587-6340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.84 of 100Reported as group
Quality
87.03
Promoting interoperability
100
Improvement activities
40
Cost
52.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions522
Removal or shaving of skin growth21
Skin biopsy172

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
940915KSMDDermatology Physician
12222522-1205UTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U-U Pediatric Dermatology CurrentSince Mar 30, 2021 Accepting new patients
Dermatology Division University of Utah Medical Center Dermatology CurrentSince Mar 30, 2021 Accepting new patients
University of Utah PastSince Mar 19, 2023 Accepting new patients

Locations

250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003

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

Interoperability endpoints

  • Direct secure messaging: megan.prouty.1@16923.direct.athenahealth.com
  • Direct secure messaging: mprouty515890@direct.med.utah.edu

Organizations & group practices 3

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 3

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1649633678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841052",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841052",
            "telephone_number": "801-581-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 E STRINGHAM AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841062490",
            "telephone_number": "801-581-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUTY",
        "first_name": "MEGAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KS",
            "license": "940915",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "12222522-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mprouty515890@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": "841320001",
            "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.