Kelly Dahlstrom, D.O.

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

11262272-1204 Issued in UT

Practice address

30 N 1900 E RM 1A071
Salt Lake City, UT 84132-2140

Phone

(801) 581-7553

NPI assigned

Jun 16, 2014

Last updated

May 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, KS2 enrollments

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 2

Specialty

Diagnostic Radiology

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kansas University Physicians IncGroup PAC ID 8921911587, 1,809 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040
• University of KS HLTH System Great Bend Campus Hospital, Great Bend, KS, CCN 170191
• Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104
• LMH Hospital, Lawrence, KS, CCN 170137

Merit-based Incentive Payment System (MIPS)

Final score

92.91 of 100Reported as apm

Quality

77.02

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdahlstrom533344@direct.kuha.org

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.

• Kansas University Physicians Inc

  • Internal Medicine Physician
  • Kansas City, KS
  • NPI 1003858333

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• Kansas University Physicians Inc

  dba KU Neurosurgery

  • Neurological Surgery Physician
  • Kansas City, KS
  • NPI 1922144856

  MO

  Medicare reassignment NPD
• University of Utah Adult Services

  dba U of U Medical Genetics

  • Clinical Genetics (M.D.) Physician
  • Salt Lake City, UT
  • NPI 1508222167
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• Kansas University Physicians Inc

  • Cardiovascular Disease Physician
  • Kansas City, KS
  • NPI 1407637291
  NPD
• Kansas University Physicians Inc

  dba KU Radiology

  • Diagnostic Radiology Physician
  • Kansas City, KS
  • NPI 1689710519
  NPD
• Kansas University Physicians Inc

  dba KU Internal Medicine

  • Internal Medicine Physician
  • Kansas City, KS
  • NPI 1699811521
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lawrence Memorial Hospital

  • General Acute Care Hospital
  • Lawrence, KS
  • NPI 1508883422
  Care Compare affiliation
• Shawnee Mission Medical Center Inc

  dba AdventHealth Shawnee Mission

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634
  Care Compare affiliation
• Shawnee Mission Medical Center Inc

  • Clinical Medical Laboratory
  • Merriam, KS
  • NPI 1235792003

  Hospital

  Care Compare affiliation
• Ukhs Great Bend, LLC

  dba The University of Kansas Health System Great Bend Campus

  • General Acute Care Hospital
  • Great Bend, KS
  • NPI 1548750417
  Care Compare affiliation
• University of Kansas Hospital Authority

  dba University of Kansas Hospital / University of Kansas Cancer Center

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1629369681
  Care Compare affiliation
• University of Kansas Hospital Authority

  dba The University of Kansas Hospital

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1649259656
  Care Compare affiliation

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1134533417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 1A071",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841322140",
            "telephone_number": "801-581-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 1A071",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841322140",
            "telephone_number": "801-581-7553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-1255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAHLSTROM",
        "first_name": "KELLY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "11262272-1204",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "UT",
            "license": "11262272-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlin Dahl, D.C
• Matthew Eric Dahl, MD
• Rachel Ann Dahl, MD
• Howard Franklin Dahle, MS, CMHC
• Michelle M Dahle, FNP
• Lisa Dahlstrom, CCC-A
• Sydney Dahmen
• Joshua Andrew Daigle
• Amanda Joyce Dailey-Hansen, APRN
• Andrew T Dailey, MD

• Neuroradiology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Neuroradiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.