Individual provider Active NPI

Bryan C Tagge, MD

  • Otolaryngology Physician
  • Salt Lake City, UT
National Provider Identifier
1164557583
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4881588-8905 Issued in UT
Practice address
22 S 900 E
Salt Lake City, UT 84102-1307
Phone
(801) 328-2522
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4881588-8905 UT Primary

Addresses

Primary practice location

22 S 900 E
Salt Lake City, UT 84102-1307

Mailing address

22 S 900 E
Salt Lake City, UT 84102-1307

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
I20040126000355 UT Practitioner - Otolaryngology 7911809314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Utah School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Ear Nose and Throat Specialists LLCGroup PAC ID 8022901610, 25 clinicians

Practice addresses (Care Compare)

22 S 900
Salt Lake City, UT 84102-1307
Phone (801) 328-2522

756 E 12200
Draper, UT 84020-9724
Phone (801) 328-2522

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.17 of 100Reported as apm
Quality
80.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Ear,Nose, and Throat Specialists LLC CurrentSince Jan 1, 2004 Accepting new patients
Ear, Nose & Throat Center of Wyoming, LLC Otolaryngology PastSince Nov 1, 2005 Accepting new patients

Locations

756 E 12200 S
Draper, UT 84020
Phone (801) 833-0579

1716 N Highway 40
Ste 100
Heber City, UT 84032

1820 Sidewinder Dr
Ste 110
Park City, UT 84060
Phone (435) 649-4106

1777 Sun Peak Dr
Ste 150
Park City, UT 84098
Phone (435) 645-0800

4063 W 12600 S
Riverton, UT 84096
Phone (801) 495-4800

4400 S 7th E
Ste 240
Salt Lake Cty, UT 84107
Phone (801) 264-4464

3738 S 900 E
Salt Lake Cty, UT 84106
Phone (801) 313-1955

7138 S Highland Dr
#213A
Salt Lake Cty, UT 84121

22 S 9th E
Slc, UT 84102
Phone (801) 328-7522

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • Direct secure messaging: entcenterslc.bryantagge@138948.advancedmd-direct.com

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 2

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164557583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021307",
            "telephone_number": "801-328-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGGE",
        "first_name": "BRYAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "4881588-8905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.