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MS. SANDRA DEANNE SPACKMAN MSN, APRN, AGANCP-BC
NPI 1164892592
Nurse Practitioner - Acute Care in Salt Lake City, UT

Active since September 28, 2015PECOS EnrolledAccepts Medicare Assignment
92.06/100
CMS Quality Rating
30 N 1900 E, 4A100, SALT LAKE CITY, UT 84132(801) 585-7676(801) 581-7735 Get Directions Write a Review

NPPES record last updated: November 18, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 18, 2021, Sep 28, 2015 (2 updates tracked since 2015).

About Ms. Sandra Deanne Spackman Msn, Aprn, Agancp-bc NPPES

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

MS. SANDRA DEANNE SPACKMAN MSN, APRN, AGANCP-BC (NPI 1164892592) is an individual acute care provider in Salt Lake City, Utah, licensed in Utah (288353-8900) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1164892592
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameMS. SANDRA DEANNE SPACKMANCredential: MSN, APRN, AGANCP-BC
Location Address30 N 1900 E, 4A100Salt Lake City, UT 84132-0002
Mailing Address30 N 1900 E, 4a100Salt Lake City, UT 84132-0002 · (801) 585-7676 · Fax (801) 581-7735
Phone(801) 585-7676
Fax(801) 581-7735
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateSeptember 28, 2015
Last NPPES UpdateNovember 18, 20212 updates tracked since enumeration
NPPES CertifiedNovember 18, 2021
✔ NPI 1164892592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
Licenses✔ Licensed in UT · 288353-8900✔ Licensed in UT · 288353-4405
30 N 1900 E, Salt Lake City, UT 84132
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming, BridgeSpan Health Company, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Sandra Deanne Spackman Msn, Aprn, Agancp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749580009
PECOS Enrollment IDI20151118002680, I20160916001033, I20160916002123
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 Reassignments

4

Medicare enrollment records show Sandra Spackman reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Utah Adult Services
0.1 mi
Cardiovascular Disease
50 NORTH MEDICAL DRIVE
Salt Lake City, UT 84132
  • Reassigned Medicare billing, Nevada, Utah and Wyoming enrollments
  • Also billed through NPI 1093119893 (Utah), NPI 1285038083 (Wyoming)
  • 21 clinicians in this Medicare group
NPI 1891190856 (801) 581-2121
Tooele Hospital Corporation
28 mi
General Acute Care Hospital
2055 N MAIN ST
Tooele, UT 84074
  • Reassigned Medicare billing, Utah enrollment
  • 5 clinicians in this Medicare group
NPI 1124090659 (435) 843-3600
Tooele Clinic Corp
28 mi
Family Medicine
1887 AARON DR STE B
Tooele, UT 84074
  • Reassigned Medicare billing, Utah enrollment
  • 98 clinicians in this Medicare group
NPI 1073512364 (435) 775-9973
Utah Navajo Health System, Incorporated
250 mi
Family Medicine
910 S 300 W
Blanding, UT 84511
  • Reassigned Medicare billing, Utah enrollment
  • 54 clinicians in this Medicare group
NPI 1457489486 (435) 678-3601

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

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
211 services176 patients
Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
153 services112 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
72 services72 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
56 services55 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
39 services37 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
28 services28 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number460009
Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County
Emergency services Birthing friendly

Mountain West Medical Center

Acute Care Hospitals · Tooele, UT
OwnershipProprietary
CMS Certification Number460014
Location2055 North Main StreetTooele, UT 84074 · Tooele County
Emergency services Birthing friendly

Uintah Basin Medical Center

Acute Care Hospitals · Roosevelt, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number460019
Location250 West 300 NorthRoosevelt, UT 84066 · Duchesne County
Emergency services Birthing friendly

Ashley Regional Medical Center

Acute Care Hospitals · Vernal, UT
OwnershipProprietary
CMS Certification Number460030
Location150 West 100 NorthVernal, UT 84078 · Uintah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84132 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.06/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.57
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

DR. ANNE WIERMAN ESTARES D.O.
Anesthesiology
30 N 1900 E, RM 4C104
SALT LAKE CITY, UT 84132
Salt Lake County (719) 314-5254
DR. JEFFREY DAVID DILLON M.D.
Anesthesiology
30 N 1900 E, ROOM 3C444
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-6393
QUINTON ALLRED PA-C
Physician Assistant (Medical)
30 N 1900 E
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7822
JEREMY ROYLE STODDART MD
Psychiatry & Neurology (Psychiatry)
30 N 1900 E, UNIVERSITY HOSPITAL,
SLC, UT 84132
Salt Lake County (801) 581-2121
DR. STEPHEN JAMES SUMMERS M.D.
Urology
30 N 1900 E, RM 3B420
SALT LAKE CITY, UT 84132
Salt Lake County (801) 213-2700
CHRISTINA MARIE DERBIDGE PHD
Psychologist (Clinical)
30 N 1900 E, ROOM SOM 1-B620
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-6228
ANDRIA HOLMES HOLT RN
Nurse Practitioner (Obstetrics & Gynecology)
30 N 1900 E
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7647
ANDY NGUYEN
Internal Medicine
30 N 1900 E, SOM4C104
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7899

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 Sandra Spackman's NPI number?

The NPI number for Sandra Spackman is 1164892592. It was assigned to this individual provider in the NPPES registry on September 28, 2015.

Where is Sandra Spackman located?

Sandra Spackman practices at 30 N 1900 E 4a100, Salt Lake City, UT 84132. The listed phone number is (801) 585-7676.

What is Sandra Spackman's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Sandra Spackman enrolled in Medicare?

Yes. Sandra Spackman is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Sandra Spackman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sandra Spackman reassigns Medicare benefits to 4 organizations: University Of Utah Adult Services (Salt Lake City, UT), Tooele Hospital Corporation (Tooele, UT), Tooele Clinic Corp (Tooele, UT) and Utah Navajo Health System, Incorporated (Blanding, UT). Each 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 Sandra Spackman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sandra Spackman accept?

Health plans from Blue Cross Blue Shield of Wyoming, BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and Select Health and 1 other insurer list Sandra Spackman as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sandra Spackman affiliated with any hospitals?

According to CMS data, Sandra Spackman is affiliated with University Of Utah Hospitals And Clinics, Mountain West Medical Center, Uintah Basin Medical Center and Ashley Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Sandra Spackman was last updated on November 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.