Individual provider Active NPI

Anilawan Fleury, MD

  • Pediatric Radiology Physician
  • Salt Lake City, UT
National Provider Identifier
1073157376
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
13166410-1205 Issued in UT
Practice address
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone
(801) 662-1000
NPI assigned
Oct 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X LT000844 PA
Nuclear Radiology Physician 2085N0904X LT000844 PA
Nuclear Radiology Physician 2085N0904X 13166410-1205 UT
Pediatric Radiology Physician 2085P0229X LT000844 PA
Diagnostic Radiology Physician 2085R0202X 13166410-1205 UT
Vascular & Interventional Radiology Physician 2085R0204X 13166410-1205 UT
Vascular & Interventional Radiology Physician 2085R0204X LT000844 PA
Pediatric Radiology Physician 2085P0229X 13166410-1205 UT Primary

Addresses

Primary practice location

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Mailing address

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (301) 332-7000

Other practice location 1

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-4000

Other practice location 2

3401 Civic Center Blvd
Philadelphia, PA 19104-4319
Phone (301) 332-7000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address anilawan.fleury@imail.org Intermountain Healthcare
Direct Messaging Address AFLEURY667678@DIRECT.MED.UTAH.EDU Direct University of Utah

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
I20231218003147 UT Practitioner - Diagnostic Radiology 6507215480 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 408-1146

Hospital & facility affiliations

  • Primary Children'S Hospital Hospital, Salt Lake City, UT, CCN 463301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LT000844PAMDNeuroradiology Physician
13166410-1205UTMDNuclear Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services CurrentSince Nov 6, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince Nov 16, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince May 15, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince May 15, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince May 15, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Dec 10, 2023 Accepting new patients
University of Utah Pediatric Services CurrentSince Nov 6, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 9, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 12, 2024 Accepting new patients
Ihc Health Services, Inc. CurrentSince Dec 10, 2023 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Nov 16, 2023 Accepting new patients
Ihc Health Services Inc Current Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5217 S State St
Ste 200
Salt Lake City, UT 84107
Phone (208) 417-5100

36 S Street St
Ste 2200
Salt Lake Cty, UT 84111
Phone (385) 622-0669

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

Interoperability endpoints

  • Direct secure messaging: afleury667678@direct.med.utah.edu

Organizations & group practices 13

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.

View all 13

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": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1073157376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "301-332-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044238",
            "country_code": "US",
            "telephone_number": "215-662-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3401 Civic Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044319",
            "country_code": "US",
            "telephone_number": "301-332-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLEURY",
        "first_name": "ANILAWAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "PA",
            "license": "LT000844",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "PA",
            "license": "LT000844",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "UT",
            "license": "13166410-1205",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "PA",
            "license": "LT000844",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "13166410-1205",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "13166410-1205",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "PA",
            "license": "LT000844",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "UT",
            "license": "13166410-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anilawan.fleury@imail.org",
            "affiliation": "Y",
            "affiliationName": "Intermountain Healthcare",
            "address_1": "100 N Mario Capecchi Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841131103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AFLEURY667678@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.