Individual provider Active NPI

Mary E Shapiro, MD

  • Pediatrics Physician
  • West Valley City, UT
National Provider Identifier
1174578611
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
61039931205 Issued in UT
Practice address
3730 W 4700 S
West Valley City, UT 84118-3457
Phone
(801) 213-9200
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 61039931205 UT Primary

Addresses

Primary practice location

3730 W 4700 S
West Valley City, UT 84118-3457

Mailing address

PO Box 510708
Salt Lake City, UT 84151-0708
Phone (801) 213-3900

Other names 1

  • Mary E Goyer Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mshapiro5472@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
I20060717000167 UT Practitioner - Pediatric Medicine 6103839139 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61039931205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Community Physicians Group Current Accepting new patients
University of Utah Pediatric Services Pediatrics Current Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 17, 2019 Accepting new patients
University of Utah Community Physicians Group CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Community Physicians Group CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Pediatric Services CurrentSince Dec 17, 2019 Accepting new patients

Locations

7495 S State St
Midvale, UT 84047
Phone (801) 213-9400

3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

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

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

3730 W 4700 S
West Valley City, UT 84129
Phone (801) 213-9200

Interoperability endpoints

  • Direct secure messaging: mshapiro5472@direct.med.utah.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1174578611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510708",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841510708",
            "telephone_number": "801-213-3900",
            "fax_number": "801-585-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 W 4700 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841183457",
            "telephone_number": "801-213-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAPIRO",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "61039931205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mshapiro5472@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": [
        {
            "first_name": "MARY",
            "last_name": "GOYER",
            "middle_name": "E",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.