Individual provider Active NPI

Ryan Joseph Carpenter, MD

  • Pediatric Cardiology Physician
  • Salt Lake City, UT
National Provider Identifier
1093218133
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
13353078-1205 Issued in UT
Practice address
81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone
(801) 213-3599
NPI assigned
Mar 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A148451 CA
Pediatrics Physician 208000000X 000 UT
Neonatal-Perinatal Medicine Physician 2080N0001X 000 UT
Pediatric Cardiology Physician 2080P0202X 13353078-1205 UT Primary

Addresses

Primary practice location

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125

Mailing address

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 213-3599

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rcarpenter642822@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
I20230725002906 UT Practitioner - Pediatric Medicine 0941661870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Georgetown University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Pediatric ServicesGroup PAC ID 0547552473, 129 clinicians

Practice addresses (Care Compare)

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 587-7109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A148451CAMDPediatrics Physician
000UTMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services CurrentSince Jun 15, 2023 Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Jun 15, 2023 Accepting new patients
University of Utah Pediatric Acuity Care Pediatrics CurrentSince Jun 15, 2023 Accepting new patients
University of Utah Pediatric Services Pediatrics Current Accepting new patients
University of Utah Pediatric Services CurrentSince Jun 15, 2023 Accepting new patients
University of Utah Pediatric Acuity Care Neonatal-Perinatal Medicine Past Accepting new patients
University of Utah Pediatric Services Pediatrics Past Accepting new patients

Locations

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

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

81 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 662-5700

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: rcarpenter642822@direct.med.utah.edu

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1093218133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131125",
            "telephone_number": "801-213-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131125",
            "telephone_number": "801-213-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "RYAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-15",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A148451",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "000",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "UT",
            "license": "000",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "UT",
            "license": "13353078-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarpenter642822@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.