Brooke Dipoma Bouwhuis, RDN in Kaysville, UT - Medicare Dietitian, Registered Provider

Brooke Dipoma Bouwhuis, RDN is a medicare enrolled "Dietitian, Registered" provider in Kaysville, Utah. Her current practice location is 958 Doris Pl, Kaysville, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 628-8543.

Brooke Dipoma Bouwhuis is licensed to practice in Utah (license number 865063) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457063034.

Contact Information

	Brooke Dipoma Bouwhuis, RDN
	958 Doris Pl, Kaysville, UT 84037-6830
	(801) 628-8543
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Brooke Dipoma Bouwhuis
Gender	Female
Speciality	Dietitian, Registered
Location	958 Doris Pl, Kaysville, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457063034
Provider Enumeration Date: 12/15/2022
Last Update Date: 12/15/2022

Medicare PECOS Information:

PECOS PAC ID: 9234501495
Enrollment ID: I20230216000877

Medical Identifiers

Medical identifiers for Brooke Dipoma Bouwhuis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457063034	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	865063 (Utah)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brooke Dipoma Bouwhuis allows following entities to bill medicare on her behalf.

Provider Name	Tanner Memorial Clinic
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1447239355 PECOS PAC ID: 4284547985 Enrollment ID: O20031110000132

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brooke Dipoma Bouwhuis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Brooke Dipoma Bouwhuis, RDN 958 Doris Pl, Kaysville, UT 84037-6830 Ph: (801) 628-8543	Brooke Dipoma Bouwhuis, RDN 958 Doris Pl, Kaysville, UT 84037-6830 Ph: (801) 628-8543

Reviews and Comments

Dietitian, Registered in Kaysville, UT

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Mrs. Trisha Sisson Brimhall, RDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 332 Creekside Way, Kaysville, UT 84037 Phone: 801-725-1933
Erica Jean Hart, R.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 460 Windcrest Way, Kaysville, UT 84037 Phone: 801-390-1412

Brooke Dipoma Bouwhuis, RDN - Medicare Dietitian in Kaysville, UT