NPIMap

Individual provider Active NPI

Dorian J Carroll, PA-C

  • Surgical Physician Assistant
  • Murray, UT
National Provider Identifier
1295989630
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5182589-1206 Issued in UT
Practice address
6095 Fashion Blvd Ste 100
Murray, UT 84107-7377
Phone
(801) 263-8700
Fax
(801) 263-8693
NPI assigned
Nov 12, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 5182589-1206 UT
Surgical Physician Assistant 363AS0400X 5182589-1206 UT Primary

Addresses

Primary practice location

6095 Fashion Blvd Ste 100
Murray, UT 84107-7377

Mailing address

6095 Fashion Blvd Ste 100
Murray, UT 84107-7377
Phone (801) 263-8700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dcarroll194516@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
I20140905002097 UT Practitioner - Physician Assistant 1153549001 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
77.8
Promoting interoperability
100
Improvement activities
40
Cost
65.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5182589-1206UTMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Sep 2, 2020 Accepting new patients
Ihc Health Services Inc CurrentSince Dec 27, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Dec 27, 2023 Accepting new patients
University of Utah Adult Services CurrentSince Sep 2, 2020 Accepting new patients
University of Utah Surgical Services CurrentSince Mar 8, 2016 Accepting new patients
Allergy Associates of Utah, P.C. Allergy & Immunology PastSince Nov 2, 2016 Accepting new patients

Locations

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

175 N Medical Dr
Slc, UT 84112
Phone (801) 581-6908

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Interoperability endpoints

  • Direct secure messaging: dcarroll194516@direct.med.utah.edu

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1295989630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6095 FASHION BLVD STE 100",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077377",
            "telephone_number": "801-263-8700",
            "fax_number": "801-263-8693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 FASHION BLVD STE 100",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077377",
            "telephone_number": "801-263-8700",
            "fax_number": "801-263-8693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "DORIAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-12",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "UT",
            "license": "5182589-1206",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "5182589-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcarroll194516@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": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.