NPIMap

Individual provider Active NPI

Nathaniel Kwak, MD

  • Gastroenterology Physician
  • Salt Lake City, UT
National Provider Identifier
1245674191
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
13181453-1205 Issued in UT
Practice address
1187 E 3900 S
Salt Lake City, UT 84124-1201
Phone
(801) 263-3041
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 13181453-1205 UT Primary
Gastroenterology Physician 207RG0100X S2824 TX

Addresses

Primary practice location

1187 E 3900 S
Salt Lake City, UT 84124-1201

Mailing address

1187 E 3900 S
Salt Lake City, UT 84124-1201
Phone (801) 263-3041

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
I20230412002556 UT Practitioner - Gastroenterology 1153639471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of Texas Medical School at Houston, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Utah Gastroenterology LLCGroup PAC ID 9830174150, 71 clinicians

Practice addresses (Care Compare)

1187 E 3900
Salt Lake City, UT 84124-1201
Phone (801) 263-3041

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.45 of 100Reported as group
Quality
47.08
Promoting interoperability
95
Improvement activities
40
Cost
75.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy22
Upper gastrointestinal (GI) endoscopy for acid reflux268

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Gastroenterology LLC Gastroenterology CurrentSince Jun 1, 2023 Accepting new patients
Utah Gastroenterology LLC Gastroenterology Current Accepting new patients
Utah Gastroenterology Gastroenterology CurrentSince Jun 1, 2023 Accepting new patients

Locations

620 Medical Dr
Ste 205
Bountiful, UT 84010
Phone (801) 298-0057

6360 S 3000 E
Ste 310
Salt Lake Cty, UT 84121
Phone (801) 944-3144

6360 S 3000 E
Ste 220
Salt Lake Cty, UT 84121
Phone (801) 944-3195

1187 E 3900 S
Salt Lake Cty, UT 84124
Phone (801) 263-3041

368 E Riverside Dr
Ste A
St George, UT 84790
Phone (435) 673-1149

Interoperability endpoints

  • FHIR API: https://4af267b3-0b17-4e37-b82c-3c19f9bce5de.gastro.prod.fhir.ema-api.com/fhir/r4/

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 and National Provider Directory roles.

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": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1245674191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1187 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241201",
            "telephone_number": "801-263-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1187 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241201",
            "telephone_number": "801-263-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAK",
        "first_name": "NATHANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "UT",
            "license": "13181453-1205",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "S2824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.