Carissa S Monroy, MD
Individual provider Active NPI Family Medicine Physician · Salt Lake City, UT
NPI 1760610349 · NPPES record last updated Dec 19, 2024
Key facts
- NPI
- 1760610349
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 74191611205 (UT)
- Practice address
- 660 S 200 E Ste 250
Salt Lake City, UT 84111-3846 - Phone
- (801) 359-2256
- NPI assigned
- Jun 23, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Utah School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Confederated Tribes of the Goshute Reservation
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
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211011001483 | TX | Practitioner - Family Practice | 9830236819 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74191611205 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Confederated Tribes of the Goshute Reservation | Current |
Accepting new patients | |
| Confederated Tribes of the Goshute Reservation | Current |
Accepting new patients |
Locations
195 Tribal Center Rd
Ibapah, UT 84034
Phone (435) 234-1302
660 S 200 E
Slc, UT 84111
Phone (801) 355-1528
660 S 200 E
Ste 250
Slc, UT 84111
Phone (801) 395-2256
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 74191611205 | UT | Yes |
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
Other names
- Carissa Sorensen
Other providers in Salt Lake City, UT
- Natalie Monk
- Sarah Monks
- Monogram Health Professional Services of Utah PLLC
- Tiana Monostory
- Ashlyn Monroe
- Erin Monroy
- Ulysses Monroy
- Leidy Dayan Monsalve-Ward
- Cole Brown Monsen
- Eric Thayne Monson
All providers in Salt Lake City, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2024. 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.