NPIMap

Individual provider Active NPI

Stephen Takasaki, DO

  • Family Medicine Physician
  • Springville, UT
National Provider Identifier
1487117248
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13479382-1204 Issued in UT
Practice address
5 E 400 N
Springville, UT 84663-1347
Phone
(801) 489-8464
Fax
(801) 798-8513
NPI assigned
Apr 9, 2019
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 13479382-1204 UT Primary

Addresses

Primary practice location

5 E 400 N
Springville, UT 84663-1347

Mailing address

336 W 100 S
Spanish Fork, UT 84660-5881
Phone (801) 798-7301

Other practice location 1

502 E Monroe St
Rapid City, SD 57701-1400
Phone (605) 755-4060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE2 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
I20241022003345 SD Practitioner - Sports Medicine 4486989993 Reassigns benefits to 1 organization
I20250306001173 NE Practitioner - Sports Medicine 4486989993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
West Virginia School of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

825 Centennial Dr
Chadron, NE 69337-9400
Phone 30843255869400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Sep 23, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince Dec 6, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince Sep 23, 2024 Accepting new patients

Locations

825 Centennial Dr
Chadron, NE 69337
Phone (308) 432-4441

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

502 E Monroe St
Rapid City, SD 57701
Phone (605) 719-4060

Interoperability endpoints

  • Direct secure messaging: stakasaki.58780@regionalhealth.sdhealthlink.net

Organizations & group practices 3

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 12

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1487117248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 W 100 S",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846605881",
            "telephone_number": "801-798-7301",
            "fax_number": "801-798-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 E 400 N",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846631347",
            "telephone_number": "801-489-8464",
            "fax_number": "801-798-8513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 E Monroe St",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577011400",
            "country_code": "US",
            "telephone_number": "605-755-4060",
            "fax_number": "605-755-4012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAKASAKI",
        "first_name": "STEPHEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "13479382-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springville, UT

Sources for this page

Verify at the official NPI Registry.