Individual provider Active NPI

Ian Schlieder, DO

  • Vascular Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1073956793
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
11262384-1204 Issued in UT
Practice address
30 N 1900 E RM 3C344
Salt Lake City, UT 84132-0002
Phone
(801) 581-8301
NPI assigned
Apr 11, 2013
Last updated
Jun 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Vascular Surgery Physician 2086S0129X 11262384-1204 UT Primary

Addresses

Primary practice location

30 N 1900 E RM 3C344
Salt Lake City, UT 84132-0002

Mailing address

30 N 1900 E RM 3C344
Salt Lake City, UT 84132-0002
Phone (801) 581-8301

Other practice location 1

24 Hospital Ave
Danbury, CT 06810-6099
Phone (509) 301-0171

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
I20210610003138 UT Practitioner - Vascular SurgeryPractitioner - General Surgery 6709218076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
At Still University, Arizona School of Dentistry & Oral HLTH, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

3903 Harrison Blvd
Suite 100
Ogden, UT 84403-2361
Phone (801) 387-8900

5444 S Green St
Summit Physician Specialists
Murray, UT 84123-5632
Phone (801) 525-7770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
19.96 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
66.54

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal32
Leg revascularization (restoring blood flow)11
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 1, 2021 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 1, 2021 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

3903 Medical Dr
Ste 100
Ogden, UT 84403
Phone (801) 387-8900

5323 S Woodrow St
Ste 101
Salt Lake City, UT 84107
Phone (801) 313-4118

5444 S Green St
Salt Lake City, UT 84123
Phone (801) 262-2647

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 6

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.

Hospital & facility affiliations 2

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1073956793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 3C344",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 3C344",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-8301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Hospital Ave",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068106099",
            "country_code": "US",
            "telephone_number": "509-301-0171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHLIEDER",
        "first_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "UT",
            "license": "11262384-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.