Individual provider Active NPI

Sara Rhiannon Maestas, MSN, APRN, NP-C

  • Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1962075788
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9254785-4405 Issued in UT
Practice address
6360 S 3000 E Ste 210
Salt Lake City, UT 84121-6972
Phone
(385) 220-9009
Fax
(801) 869-1987
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9254785-4405 UT Primary

Addresses

Primary practice location

6360 S 3000 E Ste 210
Salt Lake City, UT 84121-6972

Mailing address

15498 S Midnight View Way
Bluffdale, UT 84065-1759
Phone (801) 656-9737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220311000288 UT Practitioner - Nurse Practitioner 2668867573

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

240 E Ctr St
Provo, UT 84606-3107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Health Family Practice Family Medicine CurrentSince Jan 25, 2022 Accepting new patients

Locations

75 S 200 E
Ste 100
Provo, UT 84606
Phone (801) 844-1615

240 E Center St
Provo, UT 84606
Phone (801) 877-5801

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1962075788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15498 S MIDNIGHT VIEW WAY",
            "city": "BLUFFDALE",
            "state": "UT",
            "postal_code": "840651759",
            "telephone_number": "801-656-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216972",
            "telephone_number": "385-220-9009",
            "fax_number": "801-869-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAESTAS",
        "first_name": "SARA",
        "middle_name": "RHIANNON",
        "credential": "MSN, APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "9254785-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.