Individual provider Active NPI

Reza Nasrollahzadeh, DO

  • Sleep Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
National Provider Identifier
1053013680
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
14283601-1204 Issued in UT
Practice address
30 N Mario Capecchi Dr RM 3N100
Salt Lake City, UT 84112
Phone
(801) 408-3617
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 14283601-1204 UT Primary

Addresses

Primary practice location

30 N Mario Capecchi Dr RM 3N100
Salt Lake City, UT 84112

Mailing address

30 N Mario Capecchi Dr RM 3N100
Salt Lake City, UT 84112
Phone (801) 408-3617

Other practice location 1

10175 Gateway Blvd W Ste 140
El Paso, TX 79925-7618
Phone (915) 283-3953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230623000280 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6305204371

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Las Palmas del Sol Internal Medicine, PLLC CurrentSince Mar 26, 2023 Accepting new patients

Locations

10175 Gateway Blvd W
Ste 140
El Paso, TX 79925
Phone (915) 218-8828

10175 Gateway Blvd W
Ste 300
El Paso, TX 79925
Phone (915) 218-8828

Interoperability endpoints

  • Direct secure messaging: reza.nasrollahzadeh@hca8.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1053013680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MARIO CAPECCHI DR RM 3N100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84112",
            "telephone_number": "801-408-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MARIO CAPECCHI DR RM 3N100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84112",
            "telephone_number": "801-408-3617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10175 Gateway Blvd W Ste 140",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799257618",
            "country_code": "US",
            "telephone_number": "915-283-3953",
            "fax_number": "915-283-3954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASROLLAHZADEH",
        "first_name": "REZA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "UT",
            "license": "14283601-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.