Active NPI
Reena Patel Tam, M.D.
- Pediatrics Physician
- Salt Lake City, UT
National Provider Identifier
1215293667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 8790941-1205
- Practice address
- 295 Chipeta Way
Salt Lake City, UT 84108-1287 - Phone
- (801) 587-7400
- Fax
- (801) 662-5755
- NPI assigned
- Apr 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 8790941-1205 | UT | Primary |
Addresses
Primary practice location
295 Chipeta Way
Salt Lake City, UT 84108-1287
Mailing address
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 662-3645
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | RPATEL50163@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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Salt Lake City, UT
- NPI 1487018974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1215293667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-3645",
"fax_number": "801-662-3664"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 CHIPETA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081287",
"telephone_number": "801-587-7400",
"fax_number": "801-662-5755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "REENA",
"middle_name": "PATEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-10",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "8790941-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "RPATEL50163@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": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.