Individual provider Active NPI

Amy E Sullivan, MD

  • Maternal & Fetal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1922028166
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
47390351205 Issued in UT
Practice address
University of Utah Hospital Clinics Dept of OB/GYN
50 North Medical Drive
Salt Lake City, UT 84132-0001
Phone
(801) 581-8425
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 47390351205 UT Primary

Addresses

Primary practice location

University of Utah Hospital Clinics Dept of OB/GYN
50 North Medical Drive
Salt Lake City, UT 84132-0001

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 581-8425

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asullivan15978@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031210000839 UT Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 3971409806 Reassigns benefits to 5 organizations
I20210210001082 NV Practitioner - Obstetrics/Gynecology 3971409806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Vermont College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Specialty ServicesGroup PAC ID 2961726831, 94 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001

50 N Medical Dr
U of U Maternal Fetal Medicine
Salt Lake City, UT 84132-0100
Phone (801) 587-6336

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score
81.61 of 100Reported as group
Quality
93.24
Promoting interoperability
100
Improvement activities
40
Cost
45.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47390351205UTMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Obstetrics & Gynecology CurrentSince Apr 1, 2015 Accepting new patients
Ihc Health Services Inc CurrentSince May 1, 2007 Accepting new patients
University of Utah Specialty Services Maternal & Fetal Medicine CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Specialty Services Current Accepting new patients
Ihc Health Services Inc Current Accepting new patients
University of Utah Specialty Services Maternal & Fetal Medicine CurrentSince Feb 1, 2015 Accepting new patients
Ihc Health Services, Inc. CurrentSince May 1, 2007 Accepting new patients
Ihc Health Services Inc. CurrentSince May 1, 2007 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
University of Utah Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
University of Utah OB Diagnostic Center PastSince Jun 8, 2013 Accepting new patients
University of Utah Hospital Professional Services Past Accepting new patients

Locations

247 Bluffs Ave
Ste 102
Elko, NV 89801
Phone (775) 369-2799

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

4401 Harrison Blvd
Ste 4600
Ogden, UT 84403
Phone (801) 387-4647

5121 S Cottonwood St
Ste 130
Salt Lake City, UT 84107
Phone (801) 507-7400

5121 S Cottonwood St
Ste 100
Salt Lake City, UT 84107
Phone (801) 507-7400

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

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

50 N Medical Dr
#U
Salt Lake Cty, UT 84132
Phone (801) 581-4314

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

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

1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111

5126 W Daybreak Pkwy
South Jordan, UT 84009
Phone (801) 213-4320

Interoperability endpoints

  • Direct secure messaging: asullivan15978@direct.med.utah.edu

Organizations & group practices 18

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.

View all 18

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1922028166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-581-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF UTAH HOSPITAL CLINICS DEPT OF OB/GYN",
            "address_2": "50 NORTH MEDICAL DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "AMY",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "UT",
            "license": "47390351205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asullivan15978@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": "841320100",
            "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.