NPIMap

Individual provider Active NPI

Amandeep Godara, MD

  • Hematology & Oncology Physician
  • Salt Lake City, UT
National Provider Identifier
1487094066
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
11793611-1205 Issued in UT
Practice address
2000 Circle of Hope Dr
Salt Lake City, UT 84112-5550
Phone
(801) 646-4098
NPI assigned
Jun 27, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 270993 MA
Hematology & Oncology Physician 207RH0003X 270993 MA
Hematology & Oncology Physician 207RH0003X 11793611-1205 UT Primary

Addresses

Primary practice location

2000 Circle of Hope Dr
Salt Lake City, UT 84112-5550

Mailing address

2000 Circle of Hope Dr
Salt Lake City, UT 84112-5550
Phone (801) 646-4098

Other practice location 1

4201 Saint Antoine St
2E/Uhc
Detroit, MI 48201-2153
Phone (313) 745-4832

Other practice location 2

800 Washington St # 245
Boston, MA 02111-1552
Phone (617) 636-7498

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agodara473379@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, 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
I20200520003103 MN Practitioner - Hematology/Oncology 1951602663 Reassigns benefits to 3 organizations
I20200722001817 UT Practitioner - Hematology/Oncology 1951602663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-8793

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270993MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jun 1, 2020 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jul 31, 2020 Accepting new patients
Fairview Clinics CurrentSince Jun 1, 2020 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Jul 1, 2020 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Clinics CurrentSince Jun 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Jul 31, 2020 Accepting new patients
Fairview Health Services CurrentSince Jun 1, 2020 Accepting new patients
University of Utah Adult Services CurrentSince Jul 1, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Bronson Lakeview Hospital Internal Medicine Past Accepting new patients

Locations

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Ste 200
Minneapolis, MN 55414
Phone (612) 730-1345

516 Delaware St SE
Minneapolis, MN 55455
Phone (612) 625-3600

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

127 S 500 E
Ste 200B
Salt Lake City, UT 84102

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

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

2000 Circle of Hope Dr
Slc, UT 84112
Phone (801) 581-7840

Interoperability endpoints

  • Direct secure messaging: agodara473379@direct.med.utah.edu

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 10

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": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1487094066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 CIRCLE OF HOPE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125550",
            "telephone_number": "801-646-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CIRCLE OF HOPE DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125550",
            "telephone_number": "801-646-4098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Saint Antoine St",
            "address_2": "2E/UHC",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-745-4832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Washington St # 245",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111552",
            "country_code": "US",
            "telephone_number": "617-636-7498",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODARA",
        "first_name": "AMANDEEP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-27",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "270993",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MA",
            "license": "270993",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "UT",
            "license": "11793611-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agodara473379@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 Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.