Individual provider Active NPI

Azadeh E Poursaid, MD, PHD

  • Obstetrics & Gynecology Physician
  • Salt Lake City, UT
National Provider Identifier
1104321744
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
12914226-1205 Issued in UT
Practice address
1140 E 3900 S Ste 400
Salt Lake City, UT 84124-1269
Phone
(801) 268-6811
NPI assigned
Mar 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 12914226-1205 UT Primary

Addresses

Primary practice location

1140 E 3900 S Ste 400
Salt Lake City, UT 84124-1269

Mailing address

PO Box 198546
Atlanta, GA 30384-8546

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
I20220919001462 UT Practitioner - Obstetrics/Gynecology 7012268600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Utah School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Mark'S Gynecology Oncology Care LLCGroup PAC ID 4486736279, 17 clinicians

Practice addresses (Care Compare)

1140 E 3900
Suite 400
Salt Lake City, UT 84124-1269
Phone (801) 268-6811

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mark'S Gynecology Oncology Care LLC CurrentSince Apr 7, 2025 Accepting new patients
Circle of Life Inc Obstetrics & Gynecology CurrentSince Oct 1, 2022 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

1140 E 3900 S
Ste 400
Salt Lake Cty, UT 84124
Phone (801) 268-6811

1525 E 6000 S
Ste A
South Ogden, UT 84405
Phone (801) 337-5800

Networks

  • UT PPO D-SNP
  • UT PPO

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 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": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1104321744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198546",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E 3900 S STE 400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241269",
            "telephone_number": "801-268-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURSAID",
        "first_name": "AZADEH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "12914226-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.