NPIMap

Individual provider Active NPI

Isabella Oscar Hedwig Tcaciuc, M.D.

  • Psychiatry Physician
  • SLC, UT
National Provider Identifier
1245201870
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5211300-1205 Issued in UT
Practice address
1020 S Main St
SLC, UT 84101-3176
Phone
(801) 539-7000
Fax
(801) 539-7050
NPI assigned
Jan 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5211300-1205 UT Primary

Addresses

Primary practice location

1020 S Main St
SLC, UT 84101-3176

Mailing address

540 N Marathon Cir
SLC, UT 84108-1646
Phone (801) 363-6486

Other identifiers 3

IdentifierTypeStateIssuer
863047OtherUTDESERET MUTUAL
107029551101OtherUTINTERMOUNTAIN HEALTH CARE
942938348TCAOtherUTEDUCATORS MUTUAL

Other names 1

  • Dr. Isabella Tcaciuc Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address itcaciuc367346@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050105000272 UT Practitioner - Psychiatry 3072561224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 581-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.22 of 100Reported as group
Quality
83.74
Promoting interoperability
100
Improvement activities
40
Cost
66.87

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5211300-1205UTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Behavioral Health Services Psychiatry Current Accepting new patients
University of Utah Acuity Care Services CurrentSince Aug 10, 2019 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Aug 10, 2019 Accepting new patients
University of Utah Acuity Care Services CurrentSince Aug 10, 2019 Accepting new patients
University of Utah Acuity Care Services Current Accepting new patients
University of Utah Behavioral Health Services Psychiatry CurrentSince Aug 10, 2019 Accepting new patients
Valley Mental Health Incorporated Past Accepting new patients
Valley Behavioral Health Incorporated Psychiatry Past Accepting new patients

Locations

5965 S 900 E
#430
Murray, UT 84121
Phone (801) 261-1442

250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003

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

501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1245201870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 N MARATHON CIR",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841081646",
            "telephone_number": "801-363-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S MAIN ST",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841013176",
            "telephone_number": "801-539-7000",
            "fax_number": "801-539-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TCACIUC",
        "first_name": "ISABELLA",
        "middle_name": "OSCAR HEDWIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "5211300-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESERET MUTUAL",
            "identifier": "863047",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERMOUNTAIN HEALTH CARE",
            "identifier": "107029551101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "942938348TCA",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "itcaciuc367346@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": "ISABELLA",
            "last_name": "TCACIUC",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in SLC, UT

Sources for this page

Verify at the official NPI Registry.