Individual provider Active NPI

Mazdak A Khalighi, M.D.

  • Anatomic Pathology Physician
  • Salt Lake City, UT
National Provider Identifier
1104052653
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
8978824-1205 Issued in UT
Practice address
417 S Wakara Way
Salt Lake City, UT 84108-1436
Phone
(801) 581-2955
Fax
(801) 587-6346
NPI assigned
Jun 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology Physician 207ZC0006X 8978824-1205 UT
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD186792 OR
Anatomic Pathology Physician 207ZP0101X 8978824-1205 UT Primary

Addresses

Primary practice location

417 S Wakara Way
Salt Lake City, UT 84108-1436

Mailing address

PO Box 841052
Los Angeles, CA 90084-1052

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkhalighi103723@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
I20141202001860 UT Practitioner - Pathology 6800118811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Division University of Utah Medical CenterGroup PAC ID 9638073497, 73 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 587-6340

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score
81.84 of 100Reported as group
Quality
87.03
Promoting interoperability
100
Improvement activities
40
Cost
52.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8978824-1205UTMDClinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U-U Pediatric Dermatology CurrentSince Jan 14, 2024 Accepting new patients
Dermatology Division University of Utah Medical Center CurrentSince Jun 1, 2019 Accepting new patients

Locations

417 S Wakara Way
Salt Lake City, UT 84108
Phone (801) 581-3506

250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003

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

Organizations & group practices 2

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 3

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": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1104052653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841052",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900841052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 S WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081436",
            "telephone_number": "801-581-2955",
            "fax_number": "801-587-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIGHI",
        "first_name": "MAZDAK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-10",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "UT",
            "license": "8978824-1205",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OR",
            "license": "MD186792",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "UT",
            "license": "8978824-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhalighi103723@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.