Maelin Sorenson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

14016801-1206 Issued in UT

Practice address

650 Round Valley Dr
Park City, UT 84060-7571

Phone

(435) 333-1850

NPI assigned

Jul 24, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maelin.sorenson.1@14863.direct.athenahealth.com

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.

• Ma Bo Inc

  dba House Call Doctors

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1740461219
  Medicare reassignment
• Ma Bo Inc

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1588185581
  NPD

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1982384996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 S 80 E",
            "city": "MIDWAY",
            "state": "UT",
            "postal_code": "840496618",
            "telephone_number": "435-503-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 ROUND VALLEY DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607571",
            "telephone_number": "435-333-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "MAELIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-24",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": "PHYSICIANASSISTANT",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "14016801-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smiths Food & Drug Centers Inc (Smiths Pharmacy #72)
• Snow Country Dental Care
• Snow Creek Emergency Physicians LLC (Snow Creek Emergency & Medical Center)
• Snow Creek Emergency Physicians LLC (Family Practice @ Snow Creek)
• Solid Mental Health PLLC
• Sari Ann Soutor Farhart, PH.D.
• Janice Marie Speicher, MS, LPC
• Spenser Reed MD PLLC
• Greg Speziale
• Adriana Angela Sta Agueda

• Medical Physician Assistant in Park City, UT
• Providers in Park City, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.