Santibanez Pac Utah - Medicare Primary Care in Salt Lake City, UT

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Santibanez Pac Utah is a medicare enrolled primary clinic (Internal Medicine - Geriatric Medicine) in Salt Lake City, Utah. The current practice location for Santibanez Pac Utah is 451 E Bishop Federal Ln, Salt Lake City, Utah. For appointments, you can reach them via phone at (801) 487-7557. The mailing address for Santibanez Pac Utah is 10775 Double R Blvd, Reno, Nevada and phone number is () -.

Santibanez Pac Utah is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1881469484. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (801) 487-7557.

Contact Information

Santibanez Pac Utah
451 E Bishop Federal Ln
Salt Lake City
UT 84115-2357
(801) 487-7557
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameSantibanez Pac Utah
SpecialityInternal Medicine
Location451 E Bishop Federal Ln, Salt Lake City, Utah
Authorized Official Name and PositionJulie Roser (VP OF OPERATIONS)
Authorized Official Contact7752220045
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Santibanez Pac Utah
10775 Double R Blvd
Reno
NV 89521-8956

Ph: () -		Santibanez Pac Utah
451 E Bishop Federal Ln
Salt Lake City
UT 84115-2357

Ph: (801) 487-7557

NPI Details:

NPI Number1881469484
Provider Enumeration Date11/24/2023
Last Update Date11/24/2023

Medicare PECOS Information:

Medicare PECOS PAC ID1355785437
Medicare Enrollment IDO20240216000756

Medical Identifiers

Medical identifiers for Santibanez Pac Utah such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1881469484NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207RG0300XInternal Medicine - Geriatric Medicine (* (Not Available))Primary
363A00000XPhysician Assistant (* (Not Available))Secondary
363L00000XNurse Practitioner (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Santibanez Pac Utah acts as a billing entity for following providers:
Provider NameMary J Walker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508851890
PECOS PAC ID: 9931005923
Enrollment ID: I20031210000559
Provider NameRichard E Allen
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1831174226
PECOS PAC ID: 4981633724
Enrollment ID: I20050811000508
Provider NameDavid H Workman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1659329449
PECOS PAC ID: 2961425590
Enrollment ID: I20060110000788
Provider NameBryan R Bartholomew
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1407956121
PECOS PAC ID: 2163429911
Enrollment ID: I20061108000691
Provider NameDusan Sabol
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1790785426
PECOS PAC ID: 6002816196
Enrollment ID: I20070115000350
Provider NameDavid Kenneth Mcomber
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497901052
PECOS PAC ID: 0042370355
Enrollment ID: I20081117000503
Provider NameMichael Sebastian Galindo
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1861417057
PECOS PAC ID: 1355386749
Enrollment ID: I20100925000079
Provider NameFatima Gangotena-bernard
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1467605147
PECOS PAC ID: 5698943397
Enrollment ID: I20110725000413
Provider NameLayhong Soth
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1366602294
PECOS PAC ID: 6800054859
Enrollment ID: I20120516000362
Provider NameJorge Santibanez
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1568446672
PECOS PAC ID: 9739179847
Enrollment ID: I20130709000746
Provider NameVijay Maiya
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1902830243
PECOS PAC ID: 0042216442
Enrollment ID: I20130724001000
Provider NameJason E Crook
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194161190
PECOS PAC ID: 2668616038
Enrollment ID: I20130925000385
Provider NameRory Carrera
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1710279922
PECOS PAC ID: 7517191612
Enrollment ID: I20140717001634
Provider NameJames Barclay Anderson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992080915
PECOS PAC ID: 9739355595
Enrollment ID: I20150818003529
Provider NameIsaac J Noyes
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1952660482
PECOS PAC ID: 2668696956
Enrollment ID: I20150903001148
Provider NameJesse J Twu
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508216581
PECOS PAC ID: 5193013027
Enrollment ID: I20161010001554
Provider NameRebecca Ann Waite
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1902333065
PECOS PAC ID: 8921364712
Enrollment ID: I20171110001522
Provider NameBernard M Mutie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396255360
PECOS PAC ID: 0749547891
Enrollment ID: I20171128003813
Provider NameTyler M Nixon
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1669639985
PECOS PAC ID: 0143419739
Enrollment ID: I20180417002469
Provider NameMartin John Oates
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1346265709
PECOS PAC ID: 1557365608
Enrollment ID: I20181213002925
Provider NameCasey J Reynolds
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629551247
PECOS PAC ID: 1254674369
Enrollment ID: I20190513001348
Provider NameKimberly Ann Henne
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780248336
PECOS PAC ID: 8527392489
Enrollment ID: I20190626001673
Provider NameAmy Jackson Gilbert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144889940
PECOS PAC ID: 4981936432
Enrollment ID: I20191101001283
Provider NameKaylene Elder
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265821276
PECOS PAC ID: 6800115353
Enrollment ID: I20191210000282
Provider NameStayler Mcomie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932749538
PECOS PAC ID: 3173953106
Enrollment ID: I20200415001642
Provider NameBozena Montes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558778902
PECOS PAC ID: 5395963987
Enrollment ID: I20210106000215
Provider NameAugust Jean Teuscher
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407448970
PECOS PAC ID: 2860891157
Enrollment ID: I20210518001757
Provider NameChase C Bartholomew
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1881181618
PECOS PAC ID: 8921345695
Enrollment ID: I20210706000005
Provider NameSusan Beryl Harp
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508912643
PECOS PAC ID: 8729160775
Enrollment ID: I20220110002099
Provider NameRoberta Bostian
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972275501
PECOS PAC ID: 4385037514
Enrollment ID: I20230807003019
Provider NameSuzanne Marie Strasters
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689321275
PECOS PAC ID: 2860849270
Enrollment ID: I20231107001679
Provider NameCassandra Lopez
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1669859971
PECOS PAC ID: 4981935590
Enrollment ID: I20231227002446
Provider NameKylee Dalton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104508357
PECOS PAC ID: 6103268180
Enrollment ID: I20240522001239
Provider NameJayandra Starner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871251926
PECOS PAC ID: 6800275835
Enrollment ID: I20240528000996
Provider NameTanner D Hutchins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538819107
PECOS PAC ID: 6305286378
Enrollment ID: I20240826001552
Provider NameJonas Jen Twu
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942997382
PECOS PAC ID: 2264965789
Enrollment ID: I20241023000285
Provider NameEliza Marie Garside
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1538856687
PECOS PAC ID: 3577097096
Enrollment ID: I20241106002715

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.