Individual provider Active NPI

Shelli G Bregman, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • St George, UT
National Provider Identifier
1184666307
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
244704 Issued in NY
Practice address
1380 E Medical Center Dr
Saint George, UT 84790-2123
Phone
(435) 251-1000
NPI assigned
Jun 12, 2006
Last updated
Feb 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X PENDING PA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X PENDING PA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 244704 NY Primary

Addresses

Primary practice location

1380 E Medical Center Dr
Saint George, UT 84790-2123

Mailing address

4567 Crossroads Park Drive
Liverpool, NY 13088-3589
Phone (315) 295-2100

Other practice location 1

736 Irving Ave
9th Floor, Crouse Hospital
Syracuse, NY 13210-1687
Phone (315) 470-7396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 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

Enrollment IDStateProvider typePAC IDDetails
I20220315002454 UT Practitioner - Pathology 3971506593 Reassigns benefits to 2 organizations
I20240521002126 NV Practitioner - Pathology 3971506593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Experts IncGroup PAC ID 6204202138, 13 clinicians

Practice addresses (Care Compare)

1380 E Medical Ctr Dr
St George, UT 84790-2123
Phone (435) 251-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PENDINGPAMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Experts Inc Anatomic Pathology & Clinical Pathology CurrentSince Sep 28, 2022 Accepting new patients
Pathology Services PC Anatomic Pathology & Clinical Pathology Current Accepting new patients
Pathology Services PC Anatomic Pathology & Clinical Pathology CurrentSince Mar 21, 2022 Accepting new patients
Cytology Associates of Cny PLLC Cytopathology Current Accepting new patients
Osmond Pathology PC Anatomic Pathology & Clinical Pathology CurrentSince May 1, 2024 Accepting new patients

Locations

300 W Clarendon Ave
Ste 350
Phoenix, AZ 85013
Phone (435) 251-2208

520 E 22nd St
Lombard, IL 60148
Phone (630) 874-2542

1919 S Highland Ave
Bldg A
Lombard, IL 60148

1919 S Highland Ave
Ste 210
Lombard, IL 60148

1299 Bertha Howe Ave
Mesquite, NV 89027
Phone (702) 345-4270

736 Irving Ave
Fl 9
Syracuse, NY 13210
Phone (315) 470-7396

5700 Southwyck Blvd
Toledo, OH 43614

1303 N Main St
Cedar City, UT 84721
Phone (435) 586-2229

497 W 4800 S
Ste 201
Murray, UT 84123

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Organizations & group practices 5

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.

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1184666307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 CROSSROADS PARK DRIVE",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883589",
            "telephone_number": "315-295-2100",
            "fax_number": "315-295-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E MEDICAL CENTER DR",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847902123",
            "telephone_number": "435-251-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Irving Ave",
            "address_2": "9th Floor, Crouse Hospital",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132101687",
            "country_code": "US",
            "telephone_number": "315-470-7396",
            "fax_number": "315-470-2806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREGMAN",
        "first_name": "SHELLI",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "PA",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "244704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.