Individual provider Active NPI

Micah J. Ostrowski, MD

  • Internal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1275238198
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
14170452-1205 Issued in UT
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone
(801) 581-2121
NPI assigned
Mar 31, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 14170452-1205 UT Primary

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0001

Mailing address

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 213-9500

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009003799 UT Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1850822248

National Provider Directory

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1680220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1275238198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-213-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTROWSKI",
        "first_name": "MICAH",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-31",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "14170452-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.