Individual provider Active NPI

Clyn A Robinson, M.D.

  • Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1033117114
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5568094-1205 Issued in UT
Practice address
1050 E South Temple
Department of Anesthesia
Salt Lake City, UT 84102-1507
Phone
(801) 350-4700
Fax
(801) 350-4406
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5568094-1205 UT Primary

Addresses

Primary practice location

1050 E South Temple
Department of Anesthesia
Salt Lake City, UT 84102-1507

Mailing address

1954 Fort Union Blvd Ste 101
Salt Lake City, UT 84121-6882
Phone (801) 993-9512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040625001034 UT Practitioner - Anesthesiology 6800872268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Texas Southwestern Medical School at Dallas, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NPH Anesthesia of Utah LLCGroup PAC ID 9537584313, 91 clinicians

Practice addresses (Care Compare)

3580 W 9000
West Jordan, UT 84088-8812
Phone (972) 422-5941

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5568094-1205UTMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NPH Anesthesia of Utah, LLC Anesthesiology CurrentSince May 1, 2021 Accepting new patients
Omega Interventional Pain PLLC Past Accepting new patients
Lifetree Medical Inc Anesthesiology Past Accepting new patients

Locations

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033117114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1954 FORT UNION BLVD STE 101",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216882",
            "telephone_number": "801-993-9512",
            "fax_number": "801-733-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E SOUTH TEMPLE",
            "address_2": "DEPARTMENT OF ANESTHESIA",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021507",
            "telephone_number": "801-350-4700",
            "fax_number": "801-350-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "CLYN",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "5568094-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.