NPIMap

Individual provider Active NPI

Richard A Ofstein, MD

  • Diagnostic Radiology Physician
  • Jackson, WY
National Provider Identifier
1356326540
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
7287A Issued in WY
Practice address
St Johns Medical Center Dept of Radiology
625 E Broadway
Jackson, WY 83011
Phone
(800) 633-1905
Fax
(913) 491-0411
NPI assigned
Dec 9, 2005
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 7287A WY Primary

Addresses

Primary practice location

St Johns Medical Center Dept of Radiology
625 E Broadway
Jackson, WY 83011

Mailing address

Jackson Hole Medical Imaging PC
PO Box 9230
Jackson, WY 83002-9230
Phone (800) 633-1905

Other identifiers 3

IdentifierTypeStateIssuer
807446700MedicaidID
122813700MedicaidWY
314177OtherWYBCBS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rofstein246358@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
I20170518002352 UT Practitioner - Diagnostic Radiology 6901875418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7287AWYMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Jun 1, 2017 Accepting new patients
University of Utah Adult Services Diagnostic Radiology CurrentSince Jun 1, 2017 Accepting new patients
Little Company of Mary Ancillary Services Corporation Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Memrad Medical Group Inc Past Accepting new patients
UCLA Radiology Medical Group Diagnostic Radiology Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

127 S 500 E
Ste 600
Slc, UT 84102

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

Interoperability endpoints

  • Direct secure messaging: rofstein246358@direct.med.utah.edu

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1356326540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "JACKSON HOLE MEDICAL IMAGING PC",
            "address_2": "PO BOX 9230",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830029230",
            "telephone_number": "800-633-1905",
            "fax_number": "913-491-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST JOHNS MEDICAL CENTER DEPT OF RADIOLOGY",
            "address_2": "625 E BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83011",
            "telephone_number": "800-633-1905",
            "fax_number": "913-491-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFSTEIN",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WY",
            "license": "7287A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807446700",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122813700",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "314177",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rofstein246358@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 Jackson, WY

Sources for this page

Verify at the official NPI Registry.