Michelle Wasden, PA-C
Individual provider Active NPI Physician Assistant · Pleasant View, UT
NPI 1700875333 · NPPES record last updated Jan 17, 2017
Key facts
- NPI
- 1700875333
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 349500-1206 (UT)
- Practice address
- 1100 W 2700 N
Pleasant View, UT 84404-4791 - Phone
- (801) 475-3600
- Fax
- (801) 475-3601
- NPI assigned
- Oct 17, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ogden Clinic PC
Practice addresses (Care Compare)
5495 S 500
Suite 310
Ogden, UT 84405-7409
Phone (801) 475-3100
6112 S 1550
Ogden, UT 84405-5007
Phone (801) 475-3800
Hospital & facility affiliations
- Intermountain Health McKay-Dee Hospital
- Ogden Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050614001430 | UT | Practitioner - Physician Assistant | 3577507177 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ogden Clinic Specialty Services LLC | Physician Assistant | Current | Accepting new patients |
Locations
5495 S 500 E
Ste 310
Ogden, UT 84405
Phone (801) 475-3100
1159 12th St
Ogden, UT 84404
Phone (801) 475-3700
4650 Harrison Blvd
Ogden, UT 84403
Phone (801) 475-3481
1100 W 2700 N
Pleasant View, UT 84404
Phone (801) 475-3600
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JJJGBA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 349500-1206 | UT | Yes |
Addresses
Primary practice location
1100 W 2700 N
Pleasant View, UT 84404-4791
Mailing address
PO Box 5546
Denver, CO 80217-5546
Phone (801) 475-3600
Other providers in Pleasant View, UT
- Christina Tipton
- Total Renal Care, Inc.
- Joshua Keith Underwood
- Valley Implants Oral Surgery and Endodontics PLLC
- Barbara Vandugteren
- Bethany Wells
- Janna G Wheatley
- Nathan Wilhelm
- Zane H Williams
- Dorian M Wood
All providers in Pleasant View, UT · Physician Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.