NPIMap

Individual provider Active NPI

Tyler Andrew Smith, M.D.

  • Diagnostic Radiology Physician
  • Provo, UT
National Provider Identifier
1487004529
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
10516421-1205 Issued in UT
Practice address
1034 N 500 W
Provo, UT 84604-3380
Phone
(801) 357-4423
NPI assigned
Jun 20, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X R-16072 IA
Vascular & Interventional Radiology Physician 2085R0204X 10516421-1205 UT
Diagnostic Radiology Physician 2085R0202X 10516421-1205 UT Primary

Addresses

Primary practice location

1034 N 500 W
Provo, UT 84604-3380

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180
Phone (801) 357-4423

Other practice location 1

1801 Hickman Rd
Des Moines, IA 50314-1505
Phone (515) 282-5640

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tsmith244145@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 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
I20230518002572 UT Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 8527350800 Reassigns benefits to 3 organizations
I20250711002425 UT Practitioner - Diagnostic Radiology 8527350800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians
Utah Valley Radiology Associates IncGroup PAC ID 1759286990, 35 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-4423

1055 N 300
Suite 104
Provo, UT 84604-3344
Phone (801) 225-6246

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-16072IAMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jun 15, 2025 Accepting new patients
Tellica Imaging, LLC CurrentSince Jun 9, 2025 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 15, 2025 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince May 1, 2025 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Utah Valley Radiology Associates Inc Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology Current Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Jun 9, 2025 Accepting new patients
University of Utah Adult Services CurrentSince May 1, 2023 Accepting new patients
Riverwoods Urgent Care Center LC PastSince Oct 6, 2003 Accepting new patients

Locations

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

280 River Park Dr
Ste 120
Provo, UT 84604
Phone (601) 229-2011

1055 N 300 W
Ste 104
Provo, UT 84604
Phone (801) 357-7525

5217 S State St
Ste 200
Salt Lake City, UT 84107
Phone (208) 417-5100

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

36 S Street St
Ste 2200
Salt Lake Cty, UT 84111
Phone (385) 622-0669

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15493/brand/1/csg/1/fhir/r4

Organizations & group practices 12

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 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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1487004529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "801-357-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-357-4423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Hickman Rd",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503141505",
            "country_code": "US",
            "telephone_number": "515-282-5640",
            "fax_number": "515-282-2332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TYLER",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IA",
            "license": "R-16072",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "10516421-1205",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "10516421-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tsmith244145@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.