Salt Lake Dermatology and Aesthetics PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SALT LAKE DERMATOLOGY AND AESTHETICS PC

Practice address

250 E 300 S Ste 120
Salt Lake City, UT 84111-2418

Phone

(801) 521-5630

Fax

(801) 596-9780

NPI assigned

Mar 25, 2021

Organization subpart

No

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

Authorized official

Name

Michael C Sotiriou, MDNPI 1780097105

Title

Owner

Phone

(801) 521-5630

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00256

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Sotiriou, M.D.

  • Dermatology Physician
  • Salt Lake City, UT
  • NPI 1780097105

  Single Specialty

  Medicare reassignment NPD Authorized official
• Leo Sotiriou, MD

  • Procedural Dermatology Physician
  • Salt Lake City, UT
  • NPI 1801885199
  NPD (past)

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1669059713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E 300 S STE 120",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112418",
            "telephone_number": "801-521-5630",
            "fax_number": "801-596-9780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E 300 S STE 120",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112418",
            "telephone_number": "801-521-5630",
            "fax_number": "801-596-9780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE DERMATOLOGY AND AESTHETICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "SOTIRIOU",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-521-5630",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salt Lake County Division of Substance Abuse
• Salt Lake County Division of Youth Services
• Salt Lake County Jail
• Salt Lake County Youth Services
• Salt Lake Dental Care
• Salt Lake Donated Dental Services
• Salt Lake Endodontics
• Salt Lake Endoscopy Center
• Salt Lake Eye Associates, LLC
• Salt Lake Family Health CNTR

• Dermatology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.