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MRS. MINERVA ABELEDA DANTIS-TAN FNP-BC
NPI 1164715124
Nurse Practitioner in Salt Lake City, UT

Active since May 24, 2011PECOS Enrolled
650 E 4500 S, STE 210, SALT LAKE CITY, UT 84107(801) 288-2634(801) 288-1186 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mrs. Minerva Abeleda Dantis-tan Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MINERVA ABELEDA DANTIS-TAN FNP-BC (NPI 1164715124) is an individual nurse practitioner in Salt Lake City, Utah, licensed in Utah (5291704-4405) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164715124
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMRS. MINERVA ABELEDA DANTIS-TANCredential: FNP-BC
Location Address650 E 4500 S, STE 210Salt Lake City, UT 84107-4520
Mailing Address650 E 4500 S, Ste 210Salt Lake City, UT 84107-4520 · (801) 288-2634 · Fax (801) 288-1186
Phone(801) 288-2634
Fax(801) 288-1186
Sole ProprietorNo
Enumeration DateMay 24, 2011
Last NPPES UpdateMarch 25, 2021
NPPES CertifiedMarch 25, 2021
✔ NPI 1164715124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in UT · 5291704-4405
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 5291704-4405 (UT)
650 E 4500 S, Salt Lake City, UT 84107
Open in Google Maps ↗

Other Identifiers 1

Medicaid1164715124UT

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Minerva Abeleda Dantis-tan Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Minerva Dantis-tan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ihc Health Services Inc
0.9 mi
Multi-Specialty
5770 S 250 E
Murray, UT 84107
  • Reassigned Medicare billing, Utah enrollment
  • 1,729 clinicians in this Medicare group
NPI 1689976532 (801) 314-2210

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg J7503
Treatment-Chemotherapy · category RH002N
6 suppliers27 claims10,140 services$1.22 avg. paid by Medicare
Tacrolimus, immediate release, oral, 1 mg J7507
Treatment-Treatment - Miscellaneous · category RX029N
43 suppliers236 claims25,228 services$0.31 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
17 suppliers67 claims9,720 services$0.01 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
23 suppliers138 claims23,880 services$0.19 avg. paid by Medicare
Mycophenolic acid, oral, 180 mg J7518
Treatment-Treatment - Miscellaneous · category RX029N
25 suppliers113 claims16,760 services$0.96 avg. paid by Medicare
Sirolimus, oral, 1 mg J7520
Treatment-Treatment - Miscellaneous · category RX029N
3 suppliers22 claims765 services$2.51 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES B STINSON M.D.
Specialist
650 E 4500 S
SALT LAKE CITY, UT 84107
Salt Lake County (801) 288-2634
CHARLES JOHNSON
Counselor (Mental Health)
650 E 4500 S, #300
SALT LAKE CITY, UT 84107
Salt Lake County (801) 261-3500
MARIE KATHLEEN ACREE APRN
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)
650 E 4500 S, SUITE 300
SALT LAKE CITY, UT 84107
Salt Lake County (801) 261-3500
MS. ANDREA ROBISON
Counselor (Professional)
650 E 4500 S
SALT LAKE CITY, UT 84107
Salt Lake County (801) 906-3660
MS. DEBBIE ANN ASHTON LCSW
Social Worker (Clinical)
650 E 4500 S
MURRAY, UT 84107
Salt Lake County (801) 261-3500
DR. MELINDA J MCANULTY M.D.
Specialist
650 E 4500 S, SUITE 210
SALT LAKE CITY, UT 84107
Salt Lake County (801) 288-2634
SEAN MICHAEL PALADINI R.D.
Dietitian, Registered
650 E 4500 S
MURRAY, UT 84107
Salt Lake County (801) 747-0880
JOSEPHINE D. ABRAHAM M.D.
Internal Medicine (Nephrology)
650 E 4500 S
SALT LAKE CITY, UT 84107
Salt Lake County (801) 288-2634

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Minerva Dantis-tan's NPI number?

The NPI number for Minerva Dantis-tan is 1164715124. It was assigned to this individual provider in the NPPES registry on May 24, 2011.

Where is Minerva Dantis-tan located?

Minerva Dantis-tan practices at 650 E 4500 S Ste 210, Salt Lake City, UT 84107. The listed phone number is (801) 288-2634.

What is Minerva Dantis-tan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Minerva Dantis-tan enrolled in Medicare?

Yes. Minerva Dantis-tan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Minerva Dantis-tan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Minerva Dantis-tan reassigns Medicare benefits to Ihc Health Services Inc (Murray, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Minerva Dantis-tan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Minerva Dantis-tan was last updated on March 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.