NPIMap

Individual provider Active NPI

Mara Lee Rabin, M.D.

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1225161003
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27746451205 Issued in UT
Practice address
24 S 1100 E Ste 310
Salt Lake City, UT 84102-1500
Phone
(801) 328-1260
Fax
(801) 350-4361
NPI assigned
Mar 13, 2007
Last updated
Jan 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27746451205 UT Primary

Addresses

Primary practice location

24 S 1100 E Ste 310
Salt Lake City, UT 84102-1500

Mailing address

24 S 1100 E Ste 310
Salt Lake City, UT 84102-1500
Phone (801) 328-1260

Other identifiers 1

IdentifierTypeStateIssuer
PRA04123MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050406001021 UT Practitioner - Family Practice 1355398843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Georgetown University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpine Medical GroupGroup PAC ID 7416856109, 12 clinicians

Practice addresses (Care Compare)

24 S 1100
Suite 310
Salt Lake City, UT 84102-4507
Phone (801) 328-1260

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27746451205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Medical Group CurrentSince Jan 1, 2015 Accepting new patients
Salt Lake Family Health CNTR Family Medicine Past Accepting new patients
U.S. Healthworks Medical Group of Utah, Inc. PastSince Jun 10, 2000 Accepting new patients

Locations

887 W Center St
Orem, UT 84057
Phone (801) 328-1260

24 S 11th E
Ste 304
Salt Lake Cty, UT 84102
Phone (801) 746-4440

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

24 S 1100 E
Ste 310
Slc, UT 84102
Phone (801) 328-1260

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • Direct secure messaging: mara.rabin.1@15169.direct.athenahealth.com

Organizations & group practices 3

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 5

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1225161003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 S 1100 E STE 310",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021500",
            "telephone_number": "801-328-1260",
            "fax_number": "801-350-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 S 1100 E STE 310",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021500",
            "telephone_number": "801-328-1260",
            "fax_number": "801-350-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABIN",
        "first_name": "MARA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "27746451205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PRA04123",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.