NPIMap

Individual provider Active NPI

Shaneen Umakant Doctor, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Salt Lake City, UT
National Provider Identifier
1073747887
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
39 Issued in UT
Practice address
University of Utah Hospital
30 North 1900 East
Salt Lake City, UT 84132-0001
Phone
(801) 581-2401
NPI assigned
May 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 39 UT Primary
Emergency Medicine Physician 207P00000X 1073747887 UT

Addresses

Primary practice location

University of Utah Hospital
30 North 1900 East
Salt Lake City, UT 84132-0001

Mailing address

420 Fletcher CT
Salt Lake City, UT 84102-3022
Phone (503) 490-9890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120904000730 UT Practitioner - Emergency Medicine 2264689835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
George Washington University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Emergency PhysiciansGroup PAC ID 1153307277, 151 clinicians

Practice addresses (Care Compare)

5121 S Cottonwood St
Salt Lake City, UT 84107-5701
Phone (801) 507-9700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.98 of 100Reported as group
Quality
85.2
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1073747887UTMDEmergency Medicine Physician
39UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Emergency Physicians Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Mar 1, 2020 Accepting new patients
University of Utah Emergency Physicians Emergency Medical Services Past Accepting new patients
University of Utah Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

201 W Layton Pkwy
Layton, UT 84041
Phone (801) 543-6000

3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400

8th Ave C St E
Salt Lake City, UT 84143
Phone (218) 929-0674

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Organizations & group practices 5

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 4

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": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1073747887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 FLETCHER CT",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841023022",
            "telephone_number": "503-490-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF UTAH HOSPITAL",
            "address_2": "30 NORTH 1900 EAST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCTOR",
        "first_name": "SHANEEN",
        "middle_name": "UMAKANT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-07",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "39",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "1073747887",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.