Active NPI
Hugo G Altamirano, M.D.
- Specialist
- Provo, UT
National Provider Identifier
1417938325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 50191281205
- Practice address
- 745 N 500 W
#200
Provo, UT 84601-1472 - Phone
- (801) 375-9292
- NPI assigned
- Nov 8, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 50191281205 | UT | Primary |
Addresses
Primary practice location
745 N 500 W
#200
Provo, UT 84601-1472
Mailing address
745 N 500 W
#200
Provo, UT 84601-1472
Phone (801) 375-9292
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107010628101 | Other | UT | IHC |
| 50191281200001 | Other | UT | BLUE CROSS BLUE SHIELD |
| QM0000058767 | Other | UT | ALTIUS |
| 1200737 | Other | UT | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50191281205 | UT | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evan J Matheson | Past | Accepting new patients |
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.
-
- Clinic/Center
- Provo, UT
- NPI 1578759114
-
- Clinic/Center
- Provo, UT
- NPI 1760677686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194307200000",
"number": "1417938325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "745 N 500 W",
"address_2": "#200",
"city": "PROVO",
"state": "UT",
"postal_code": "846011472",
"telephone_number": "801-375-9292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "745 N 500 W",
"address_2": "#200",
"city": "PROVO",
"state": "UT",
"postal_code": "846011472",
"telephone_number": "801-375-9292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALTAMIRANO",
"first_name": "HUGO",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-08",
"last_updated": "2007-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "UT",
"license": "50191281205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107010628101",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "50191281200001",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM0000058767",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1200737",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.