Active NPI
Adriene Pavek
- Internal Medicine Physician
- Salt Lake City, UT
National Provider Identifier
1255038303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- PG230884
- Practice address
- 27 S Mario Capecchi Dr
Salt Lake City, UT 84112-5888 - Phone
- (801) 581-6437
- NPI assigned
- Feb 9, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | PG230884 | OR | Primary |
Addresses
Primary practice location
27 S Mario Capecchi Dr
Salt Lake City, UT 84112-5888
Mailing address
27 S Mario Capecchi Dr
Salt Lake City, UT 84112-5888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260609001615 | OR | Order and Referring Only - Internal Medicine | 1557832755 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PG230884 | OR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779667200000",
"number": "1255038303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 S MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841125888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 S MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841125888",
"telephone_number": "801-581-6437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVEK",
"first_name": "ADRIENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-09",
"last_updated": "2026-05-25",
"certification_date": "2026-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "PG230884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 May 25, 2026; 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.