Komal Rastogi, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

10714567-1205 Issued in UT

Practice address

2965 W 3500 S
West Valley City, UT 84119-3602

Phone

(801) 965-3600

NPI assigned

Jun 11, 2012

Last updated

Nov 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in UT, OH, FL, OR4 enrollments

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 4

Specialty

Neurology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Granger Medical Specialists LLCGroup PAC ID 4587074356, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Symbii Home Health South Home health agency, Murray, UT, CCN 467342
• St Mark's Hospital Hospital, Salt Lake City, UT, CCN 460047
• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• Lone Peak Hospital Hospital, Draper, UT, CCN 460060
• University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
• Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• UT PPO D-SNP
• UT PPO

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

• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Valley City, UT
  • NPI 1184657041

  Neurology

  Medicare reassignment Care Compare group NPD
• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  Medicare reassignment Care Compare group NPD
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment NPD
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272
  Medicare reassignment NPD
• Nchmd Inc

  • Hematology & Oncology Physician
  • Naples, FL
  • NPI 1831120195
  Medicare reassignment NPD
• Silverton Health

  dba Legacy Silverton Medical Center

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Medicare reassignment NPD
• Virtual Neurology Texas PLLC

  • Neurology Physician
  • Irving, TX
  • NPI 1467092114

  UT

  Medicare reassignment NPD
• Granger Medical Specialists, LLC

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1497441539
  NPD
• Landmark Hospital of Southwest Florida, LLC

  • Long Term Care Hospital
  • Lehigh Acres, FL
  • NPI 1932595659
  NPD
• Nchmd, Inc

  • Durable Medical Equipment & Medical Supplies
  • Naples, FL
  • NPI 1033904651
  NPD
• Silverton Health

  dba Legacy Molalla Family Medicine

  • Clinic/Center
  • Molalla, OR
  • NPI 1861116055
  NPD

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

• Catholic Health Initiatives Colorado

  dba Holy Cross Hospital - Davis

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1346945839
  Care Compare affiliation
• Exemplar Healthcare, Inc.

  dba Symbii Home Health South

  • Home Health Agency
  • Murray, UT
  • NPI 1164901484
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Intermountain Medical Center

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Lone Peak Hospital, Inc.

  dba Lone Peak Hospital

  • General Acute Care Hospital
  • Draper, UT
  • NPI 1770821571
  Care Compare affiliation
• Northern Utah Healthcare Corporation

  dba St. Mark's Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation
• University of Utah

  dba Huntsman Mental Health Institute

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1487734976
  Care Compare affiliation
• University of Utah

  dba University Health Care Hospitals and Clinics

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870
  Care Compare affiliation
• University of Utah

  dba University Health Care

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  Care Compare affiliation

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1063774669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1492 W Antelope Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840411141",
            "country_code": "US",
            "telephone_number": "801-773-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11215 Metro Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339661206",
            "country_code": "US",
            "telephone_number": "239-208-2206",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2801 N Gantenbein Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271623",
            "country_code": "US",
            "telephone_number": "503-413-8407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 Eaton Ave",
            "address_purpose": "LOCATION",
            "city": "Hamilton",
            "state": "OH",
            "postal_code": "450132767",
            "country_code": "US",
            "telephone_number": "513-867-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RASTOGI",
        "first_name": "KOMAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME166731",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD219186",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD61523148",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "UT",
            "license": "10714567-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3007519",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krastogi907046@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "630 Eaton Ave",
            "city": "Hamilton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450132767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Martin I Radwin, MD
• Faiza Rafi, PHD
• Winter Ralphs
• Shae Ramirez
• Trent Rasmussen, MD
• Gunnar Rawlings, DPT
• Recovery Innovations Inc (RI International)
• Recovery Innovations Inc (RI International)
• Katarina Reed, PHARMD
• Reeva LTC LLC

• Neurology Physician in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Neurology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.