Individual provider Active NPI

Emily Rosenthal, MD

  • Pediatric Cardiology Physician
  • Salt Lake City, UT
National Provider Identifier
1417607680
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
14210460-1205 Issued in UT
Practice address
81 S Mario Capecchi Dr RM 4E217
Salt Lake City, UT 84112-5888
Phone
(801) 581-2121
NPI assigned
Mar 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 14210460-1205 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

81 S Mario Capecchi Dr RM 4E217
Salt Lake City, UT 84112-5888

Mailing address

81 S Mario Capecchi Dr RM 4E217
Salt Lake City, UT 84112-5888
Phone (801) 581-2121

Other practice location 1

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098
Phone (503) 494-8211

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
I20250728003158 UT Order and Referring Only - Family PracticePractitioner - Family Practice 8921484148

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": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1417607680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 S MARIO CAPECCHI DR RM 4E217",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125888",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 S MARIO CAPECCHI DR RM 4E217",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125888",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393098",
            "country_code": "US",
            "telephone_number": "503-494-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "UT",
            "license": "14210460-1205",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.