Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carissa Annette Ellsworth, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1831458744

Carissa Annette Ellsworth, PHYSICIANASSISTANT is a Physician Assistant in Layton, Utah. Qualified in 2012, 14 years ago. Practices with Summit Medical Center LLC, a 5-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Dakota.

Years since qualifying
14
Licensed in
ND
In the registry since
2012
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Practice location Address checks out

1600 W Antelope Dr
Layton, UT 84041-1142
Phone: (801) 807-7177
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1138 W 3140 N, Pleasant View, UT 84414-2683 — (801) 450-7525

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PAC-0481 (ND)

Record details

NPI number1831458744
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedMay 11, 2012
Last updated in NPPESOctober 23, 2024
Certification dateOctober 23, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Summit Medical Center Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Layton