Organization Active NPI

Peak Vascular Professionals

  • Vascular & Interventional Radiology Physician
  • South Ogden, UT
National Provider Identifier
1063388346
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
PEAK VASCULAR PROFESSIONALS
Practice address
955 Chambers St Ste 200
South Ogden, UT 84403-4519
Phone
(801) 441-9665
NPI assigned
Oct 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Authorized official

Name
Shawn Dale Isaeff, MDNPI 1205803897
Title
Manager
Phone
(801) 441-9665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

955 Chambers St Ste 200
South Ogden, UT 84403-4519

Mailing address

955 Chambers St Ste 200
Ogden, UT 84403-4519
Phone (801) 252-6774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260107001125 UT Part B Supplier - Clinic/Group Practice 3375029663 Receives reassigned benefits from 1 practitioner
Practice locations: Ogden, UT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2337327Peak Vascular Professionals LLC955 Chambers Street, Ste 200, Ogden, UT 84403Certificate of waiverJan 20, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1063388346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 CHAMBERS ST STE 200",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034519",
            "telephone_number": "801-252-6774",
            "fax_number": "801-515-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 CHAMBERS ST STE 200",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034519",
            "telephone_number": "801-441-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK VASCULAR PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "ISAEFF",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-441-9665",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.