Organization Active NPI

Tomas E Liskutin MD PC

  • Orthopaedic Surgery Physician
  • Murray, UT
National Provider Identifier
1184450587
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
TOMAS E LISKUTIN MD PC
Practice address
5316 S Woodrow St Ste 200
Murray, UT 84107-5479
Phone
(801) 747-1020
NPI assigned
Sep 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Authorized official

Name
Tomas Liskutin, MDNPI 1770089005
Title
President
Phone
(801) 747-1020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

5316 S Woodrow St Ste 200
Murray, UT 84107-5479

Mailing address

5316 S Woodrow St Ste 200
Murray, UT 84107-5479
Phone (801) 747-1020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250123000529 UT Part B Supplier - Clinic/Group Practice 9739618596 Receives reassigned benefits from 1 practitioner
Practice locations: Murray, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726012800000",
    "number": "1184450587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5316 S WOODROW ST STE 200",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075479",
            "telephone_number": "801-747-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5316 S WOODROW ST STE 200",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075479",
            "telephone_number": "801-747-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOMAS E LISKUTIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A",
        "authorized_official_last_name": "LISKUTIN",
        "authorized_official_first_name": "TOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-747-1020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.