Individual provider Active NPI

Sean M. Tanino, MD

  • Pediatrics Physician
  • Salt Lake City, UT
National Provider Identifier
1295475218
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
13521412-1205 Issued in UT
Practice address
Helix 30 N Mario Capecchi Drive RM 3N100
Salt Lake City, UT 84112
Phone
(801) 581-2121
NPI assigned
Mar 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13521412-1205 UT
Pediatrics Physician 208000000X 13521412-1205 UT Primary

Addresses

Primary practice location

Helix 30 N Mario Capecchi Drive RM 3N100
Salt Lake City, UT 84112

Mailing address

Helix 30 N Mario Capecchi Drive RM 3N100
Salt Lake City, UT 84112
Phone (801) 581-2121

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
I20230829000966 UT Order and Referring Only - Internal MedicinePractitioner - Internal MedicinePractitioner - Pediatric Medicine 9830552538

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Duke University School of Medicine, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 299
Salt Lake City, UT 84110

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": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1295475218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HELIX 30 N MARIO CAPECCHI DRIVE RM 3N100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84112",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HELIX 30 N MARIO CAPECCHI DRIVE RM 3N100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84112",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANINO",
        "first_name": "SEAN",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "13521412-1205",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "13521412-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.