Carissa Annette Ellsworth, PHYSICIAN ASSISTANT
NPI 1831458744ActiveIndividual· Physician Assistant, Medical· Layton, UT
Physician Assistant, Medical (PHYSICIAN ASSISTANT) with Summit Medical Center LLC, practicing in Layton, Utah. 171 Medicare patients in 2024, $16,011 paid; nearly all of their 241 Part D prescriptions were generic (93%).
Overview
| NPI | 1831458744 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHYSICIAN ASSISTANT |
| Sole proprietor | No |
| NPI issued | May 11, 2012 |
| Last updated in NPPES | Oct 23, 2024 |
| Certified by provider | Oct 23, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | PAC-0481 | ND |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (AZ); Practitioner - Physician Assistant (UT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 171 |
|---|---|
| Services billed | 188 across 7 procedure codes |
| Paid by Medicare | $16,011 |
Part D prescriptions in 2024
| Prescriptions (claims) | 241 · 299 30-day fills |
|---|---|
| Patients | 159 |
| Total drug cost | $6,343 |
| Generic share | 93% of claims |
Education and affiliations
| Graduation year | 2012 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Summit Medical Center LLCTaylorsville, UT · 5 clinicians
Other facilities
- Independence Home HealthHome health agency · Woods Cross, UT
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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