Individual provider Active NPI

Elizabeth A Graul, M.D.

  • Gynecology Physician
  • Salt Lake City, UT
National Provider Identifier
1417074865
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
2751391-1205 Issued in UT
Practice address
3970 S 700 E Ste 14
Salt Lake City, UT 84107-2585
Phone
(385) 257-6284
Fax
(801) 281-9681
NPI assigned
Mar 22, 2007
Last updated
Oct 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 2751391-1205 UT Primary

Addresses

Primary practice location

3970 S 700 E Ste 14
Salt Lake City, UT 84107-2585

Mailing address

3970 S 700 E Ste 14
Salt Lake City, UT 84107-2585
Phone (385) 257-6284

Other practice location 1

348 E 4500 S
Suite 200
Salt Lake City, UT 84107-3906
Phone (801) 262-9800

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
I20050617000196 UT Practitioner - Obstetrics/Gynecology 9032151089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Utah School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phase II Center for Womens HealthGroup PAC ID 2163323692, 4 clinicians

Practice addresses (Care Compare)

348 E 4500
Suite 200
Murray, UT 84107-8509
Phone (385) 257-6284

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2751391-1205UTMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phase II Center for Womens Health Gynecology CurrentSince Jun 15, 1998 Accepting new patients
Phase II St George Inc PastSince Jun 7, 2005 Accepting new patients

Locations

348 E 4500 S
Ste 200
Salt Lake Cty, UT 84107
Phone (385) 257-6284

3970 S 7th E
Ste 14
Salt Lake Cty, UT 84107
Phone (801) 261-3605

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1417074865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 S 700 E STE 14",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072585",
            "telephone_number": "385-257-6284",
            "fax_number": "801-281-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 S 700 E STE 14",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072585",
            "telephone_number": "385-257-6284",
            "fax_number": "801-281-9681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "348 E 4500 S",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841073906",
            "country_code": "US",
            "telephone_number": "801-262-9800",
            "fax_number": "801-262-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAUL",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "UT",
            "license": "2751391-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.