Shane Nicholas Weber, D.O.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

11085898-1204 Issued in UT

Practice address

30 N 1900 E RM 1A07
Salt Lake City, UT 84132-0002

Phone

(801) 581-7553

NPI assigned

Jun 9, 2014

Last updated

Jun 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Diagnostic Radiology

Education

Pacific Medical College, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tooele Valley Imaging LLCGroup PAC ID 2466624630, 24 clinicians

Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Wasatch Vascular Center LLCGroup PAC ID 1951726967, 6 clinicians

Utah Imaging Associates IncGroup PAC ID 1355394537, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
• St Mark's Hospital Hospital, Salt Lake City, UT, CCN 460047
• Lakeview Hospital Hospital, Bountiful, UT, CCN 460042
• Lone Peak Hospital Hospital, Draper, UT, CCN 460060
• Brigham City Community Hospital Hospital, Brigham City, UT, CCN 460017

Merit-based Incentive Payment System (MIPS)

Final score

93.06 of 100Reported as group

Quality

100

Improvement activities

40

Cost

76.86

Merit-based Incentive Payment System (MIPS)

Final score

54.26 of 100Reported as group

Quality

56.16

Promoting interoperability

0

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shane.weber.p121@direct.aac.nextgenshare.com
• Direct secure messaging: shane.weber.p122@direct.aac.nextgenshare.com

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.

• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Valley City, UT
  • NPI 1184657041
  Medicare reassignment Care Compare group NPD
• Tooele Valley Imaging, LLC

  dba First Choice Imaging

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Tooele, UT
  • NPI 1699004499
  Medicare reassignment Care Compare group NPD
• Wasatch Vascular Center LLC

  • Vascular & Interventional Radiology Physician
  • Salt Lake City, UT
  • NPI 1558905398
  Medicare reassignment Care Compare group NPD
• Utah Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Farmington, UT
  • NPI 1629076229
  Medicare reassignment Care Compare group
• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  Medicare reassignment NPD
• Green River Radiology, P.C.

  dba RAYUS Radiology

  • Diagnostic Radiology Physician
  • Pleasant Grove, UT
  • NPI 1508533878
  Medicare reassignment NPD
• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Provo, UT
  • NPI 1093764805
  Medicare reassignment NPD
• Tanner Memorial Clinic

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1447239355
  Medicare reassignment NPD
• Wasatch Imaging LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Sandy, UT
  • NPI 1679645139
  Medicare reassignment NPD
• Granger Medical Clinic PC

  • Medical Specialty Clinic/Center
  • Sandy, UT
  • NPI 1871320028
  NPD
• Granger Medical Specialists, LLC

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1497441539
  NPD
• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD

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

• Brigham City Community Hospital, Inc.

  dba Brigham City Community Hospital

  • General Acute Care Hospital
  • Brigham City, UT
  • NPI 1245282227
  Care Compare affiliation
• Columbia Ogden Medical Center, Inc.

  dba Ogden Regional Medical Center

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636
  Care Compare affiliation
• Hospital Corporation of Utah

  dba Lakeview Hospital

  • General Acute Care Hospital
  • Bountiful, UT
  • NPI 1528010451
  Care Compare affiliation
• Lone Peak Hospital, Inc.

  dba Lone Peak Hospital

  • General Acute Care Hospital
  • Draper, UT
  • NPI 1770821571
  Care Compare affiliation
• Northern Utah Healthcare Corporation

  dba St. Mark's Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1467865329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 1A07",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 1A07",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-7553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18101 Oakwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244089",
            "country_code": "US",
            "telephone_number": "313-436-2583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBER",
        "first_name": "SHANE",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "5101021222",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "11085898-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Micole Weber
• Laura Catherine Weber, DNP, NP-C
• Lindsay Weber
• Matthew J Weber, DPT
• Richard Weber, LCSW
• Steven Weber, RPH
• Tiffany Kristen Weber, MD
• Braydon Webster
• Carl McKay Webster
• Holly F Webster, PNP

• Vascular & Interventional Radiology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Vascular & Interventional Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.