Active NPI
Amanda Ann Larsen, MD
- Neurology Physician
- Murray, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 12401792-1205
- Practice address
- 5171 S Cottonwood St Ste 810
Murray, UT 84107-5705 - Phone
- (801) 507-9800
- NPI assigned
- Mar 27, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 12401792-1205 | UT | Primary |
Addresses
Primary practice location
5171 S Cottonwood St Ste 810
Murray, UT 84107-5705
Mailing address
PO Box 27128
Salt Lake City, UT 84132-0001
Other practice location 1
175 N Medical Drive East
Salt Lake City, UT 84132-0001
Phone (801) 585-5405
Other names 1
- Amanda Ellgen
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark LLC/ Office Ally |
| Direct Messaging Address | aellgen439925@direct.med.utah.edu | Direct | University of Utah |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- University of Colorado School of Medicine, Aurora, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
5171 S Cottonwood St
Suite 810
Murray, UT 84107-5705
Phone (801) 507-9800
Hospital & facility affiliations
- LDS Hospital
- Intermountain Health Logan Regional Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.77 of 100
- Quality
- 91.47
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.42
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12401792-1205 | UT | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Colorado West Healthcare System | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Colorado West Healthcare System | Current | Accepting new patients |
Locations
2351 G Rd
Grand Junction, CO 81505
Phone (970) 242-0920
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
5171 S Cottonwood St
Ste 810
Salt Lake City, UT 84107
Phone (801) 507-9800
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
175 N Medical Dr
Slc, UT 84112
Phone (801) 581-6908
1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479
Interoperability endpoints
- aellgen439925@direct.med.utah.edu
Organizations & group practices 8
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.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- General Practice Physician
- Salt Lake City, UT
- NPI 1114321981
-
- General Acute Care Hospital
- Grand Junction, CO
- NPI 1497723407
-
- Body Imaging Physician
- Logan, UT
- NPI 1982732186
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Cardiovascular Disease Physician
- Salt Lake City, UT
- NPI 1124422928
-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
-
- Plastic Surgery Physician
- Grand Junction, CO
- NPI 1205239555
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Logan, UT
- NPI 1831108497
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1528078581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764115200000",
"number": "1992333868",
"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": "841320001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5171 S COTTONWOOD ST STE 810",
"city": "MURRAY",
"state": "UT",
"postal_code": "841075705",
"telephone_number": "801-507-9800"
}
],
"practiceLocations": [
{
"address_1": "175 N Medical Drive East",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841320001",
"country_code": "US",
"telephone_number": "801-585-5405",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LARSEN",
"first_name": "AMANDA",
"middle_name": "ANN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-27",
"last_updated": "2025-11-26",
"certification_date": "2025-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "UT",
"license": "12401792-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC/ Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "aellgen439925@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": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "AMANDA",
"last_name": "ELLGEN",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.