Individual provider Active NPI

Bradley A Dreifuss, MD

  • Emergency Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1487852281
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
76839741205 Issued in UT
Practice address
30 North 1900 East 1C026
University of Utah Division of Emergency Medicine
Salt Lake City, UT 84132
Phone
(503) 502-0775
NPI assigned
Jul 3, 2007
Last updated
Jul 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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 76839741205 UT Primary
Emergency Medicine Physician 207P00000X 8555A WY
Emergency Medicine Physician 207P00000X TP827 KY

Addresses

Primary practice location

30 North 1900 East 1C026
University of Utah Division of Emergency Medicine
Salt Lake City, UT 84132

Mailing address

30 North 1900 East 1C026
University of Utah Division of Emergency Medicine
Salt Lake City, UT 84132
Phone (503) 502-0775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20120725000253 AZ Practitioner - Emergency Medicine 1850415704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.34 of 100Reported as apm
Quality
74.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76839741205UTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group Emergency Medicine CurrentSince Jul 1, 2012 Accepting new patients
Banner-University Medical Group CurrentSince Jul 1, 2012 Accepting new patients
University of Utah Emergency Physicians Past Accepting new patients
Pegasus Emergency Group Wyoming LLC Emergency Medicine Past Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine Past Accepting new patients
University of Utah Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

1501 N Campbell Ave
#245575
Tucson, AZ 85724

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1487852281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NORTH 1900 EAST 1C026",
            "address_2": "UNIVERSITY OF UTAH DIVISION OF EMERGENCY MEDICINE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84132",
            "telephone_number": "503-502-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NORTH 1900 EAST 1C026",
            "address_2": "UNIVERSITY OF UTAH DIVISION OF EMERGENCY MEDICINE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84132",
            "telephone_number": "503-502-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREIFUSS",
        "first_name": "BRADLEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-03",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "76839741205",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WY",
            "license": "8555A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "TP827",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.