NPIMap

Individual provider Active NPI

Marshall E. Smith, MD

  • Pediatric Otolaryngology Physician
  • Salt Lake City, UT
National Provider Identifier
1154411783
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
333284-1205 Issued in UT
Practice address
100 N Medical Dr
Salt Lake City, UT 84113-1103
Phone
(801) 581-2121
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 333284-1205 UT
Pediatric Otolaryngology Physician 207YP0228X 333284-1205 UT Primary

Addresses

Primary practice location

100 N Medical Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 581094
Salt Lake City, UT 84158-1094
Phone (801) 581-2121

Other identifiers 3

IdentifierTypeStateIssuer
D1815MedicaidUT
805065800MedicaidID
990009279OtherUTRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msmith28635@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109000453 UT Practitioner - Pediatric MedicinePractitioner - Otolaryngology 9739102492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Pediatric ServicesGroup PAC ID 0547552473, 129 clinicians
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

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

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
  • LDS Hospital Hospital, Salt Lake City, UT, CCN 460006

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 9, 2017 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 9, 2017 Accepting new patients
University of Utah Pediatric Services Past Accepting new patients

Locations

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

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

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.

Hospital & facility affiliations 4

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1154411783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 581094",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841581094",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARSHALL",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "333284-1205",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "UT",
            "license": "333284-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D1815",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805065800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "990009279",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msmith28635@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": "841320100",
            "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.