NPIMap

Individual provider Active NPI

Shahrzad Roya Woodbridge, DO

  • Emergency Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1467934455
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO214548 Issued in OR
Practice address
30 N 1900 E
Som 1C026
Salt Lake City, UT 84132
Phone
(801) 581-2272
NPI assigned
Sep 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 12404265-1204 UT
Emergency Medicine Physician 207P00000X O-1794 ID
Emergency Medicine Physician 207P00000X DO214548 OR Primary

Addresses

Primary practice location

30 N 1900 E
Som 1C026
Salt Lake City, UT 84132

Mailing address

30 N 1900 E
Som 1C026
Salt Lake City, UT 84132-0002

Other practice location 1

200 University Pkwy
Yakima, WA 98901-9539
Phone (509) 452-5100

Other identifiers 1

IdentifierTypeStateIssuer
201844875WAMedicaidWA

Other names 1

  • Shahrzad R. Dow Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230522002916 ID Practitioner - Emergency Medicine 2668877739 Reassigns benefits to 1 organization
I20230623002820 OR Practitioner - Emergency Medicine 2668877739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, shared by 18 NPIs, 995 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

351 SW 9TH St
Ontario, OR 97914-2639
Phone (541) 881-7000

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-1794IDMDEmergency Medicine Physician
DO214548ORMDEmergency Medicine Physician
12404265-1204UTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America, LLC Emergency Medicine CurrentSince May 15, 2023 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince May 15, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jun 14, 2023 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • Direct secure messaging: swoodbridge2756748@direct.trinity-health.org

Organizations & group practices 4

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

Hospital & facility affiliations 7

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": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1467934455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E",
            "address_2": "SOM 1C026",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E",
            "address_2": "SOM 1C026",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84132",
            "telephone_number": "801-581-2272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 University Pkwy",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989019539",
            "country_code": "US",
            "telephone_number": "509-452-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODBRIDGE",
        "first_name": "SHAHRZAD",
        "middle_name": "ROYA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "12404265-1204",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-1794",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "DO214548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201844875WA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAHRZAD",
            "last_name": "DOW",
            "middle_name": "R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.