NPIMap

Individual provider Active NPI

Johanna Sage Salay, MS, MD

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1871013839
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11414333-1205 Issued in UT
Practice address
375 S Chipeta Way Ste a
Salt Lake City, UT 84108-1261
Phone
(801) 581-7914
NPI assigned
Jun 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LP04109 RI
Family Medicine Physician 207Q00000X 11414333-1205 UT Primary

Addresses

Primary practice location

375 S Chipeta Way Ste a
Salt Lake City, UT 84108-1261

Mailing address

375 S Chipeta Way Ste a
Salt Lake City, UT 84108-1261
Phone (801) 581-7914

Other identifiers 1

IdentifierTypeStateIssuer
LP04109OtherRIRHODE ISLAND LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210916000603 TX Practitioner - Family Practice 6305279217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

34 Navajo Rte
Sanostee Health Station
Sanostee, NM 87461
Phone (505) 732-2484

Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401

P O Box
160 Attn Business Office
Shiprock, NM 87420-0160

PO Box
Suite 160
Shiprock, NM 87420-0160

Hospital & facility affiliations

  • Northern Navajo Medical Center Hospital, Shiprock, NM, CCN 320059
  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP04109RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Sep 6, 2021 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital Current Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Sep 6, 2021 Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1871013839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 S CHIPETA WAY STE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081261",
            "telephone_number": "801-581-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S CHIPETA WAY STE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081261",
            "telephone_number": "801-581-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAY",
        "first_name": "JOHANNA",
        "middle_name": "SAGE",
        "credential": "MS, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "LP04109",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11414333-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHODE ISLAND LICENSE",
            "identifier": "LP04109",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.