Individual provider Active NPI

Ethan S. Rosenfeld, M.D.

  • Vascular Surgery Physician
  • Murray, UT
National Provider Identifier
1609223064
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
12792806-1205 Issued in UT
Practice address
5295 S Commerce Dr Ste 550
Murray, UT 84107-4736
Phone
(801) 313-4110
NPI assigned
May 16, 2016
Last updated
Dec 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X D88188 MD
Surgery Physician 208600000X MD047589 DC
Vascular Surgery Physician 2086S0129X MD2024-1035 NM
Vascular Surgery Physician 2086S0129X 12792806-1205 UT Primary

Addresses

Primary practice location

5295 S Commerce Dr Ste 550
Murray, UT 84107-4736

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180

Other practice location 1

30 N 1900 E Rm 3C344
Salt Lake City, UT 84132-0002
Phone (801) 213-2598

Other practice location 2

2150 Pennsylvania Ave NW
Washington, DC 20037-3201
Phone (202) 741-3000

Other practice location 3

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

Other identifiers 3

IdentifierTypeStateIssuer
MD2024-1035OtherNMNM LICENSE
D88188OtherMDMD LICENSE
MD047589OtherDCDC LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Bluemark LLC/ Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241031003229 NM Practitioner - Vascular Surgery 7416344452 Reassigns benefits to 1 organization
I20260126000558 UT Practitioner - Vascular Surgery 7416344452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
State University of New York at Buffalo School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

5295 S Commerce Dr
Suite 550
Murray, UT 84107-4736
Phone (801) 313-4110

5323 S Woodrow St
Suite 101
Murray, UT 84107-5843
Phone (801) 313-4118

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD047589DCMDSurgery Physician
D88188MDMDSurgery Physician
MD2024-1035NMMDVascular Surgery Physician
12792806-1205UTMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Presbyterian Healthcare Services Surgery CurrentSince Nov 1, 2024 Accepting new patients
Presbyterian Healthcare Services CurrentSince Nov 1, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Feb 1, 2026 Accepting new patients
Ihc Health Services Inc CurrentSince Feb 1, 2026 Accepting new patients

Locations

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

201 Cedar St SE
Ste 800
Albuquerque, NM 87106
Phone (505) 563-2500

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

3903 Medical Dr
Ste 100
Ogden, UT 84403
Phone (801) 387-8900

5295 S Commerce Dr
Ste 550
Salt Lake City, UT 84107
Phone (801) 313-4110

5323 S Woodrow St
Ste 101
Salt Lake City, UT 84107
Phone (801) 313-4118

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

1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479

Interoperability endpoints

  • Direct secure messaging: erosenfeld19868@gwmfa.direct-ci.com
  • Direct secure messaging: erosenfeld557247@direct.hopkinsmedicine.org

Organizations & group practices 7

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 2

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": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1609223064",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5295 S COMMERCE DR STE 550",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074736",
            "telephone_number": "801-313-4110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N 1900 E Rm 3C344",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320002",
            "country_code": "US",
            "telephone_number": "801-213-2598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 Pennsylvania Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200373201",
            "country_code": "US",
            "telephone_number": "202-741-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Central Ave SE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871064930",
            "country_code": "US",
            "telephone_number": "505-841-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENFELD",
        "first_name": "ETHAN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-16",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D88188",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "DC",
            "license": "MD047589",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NM",
            "license": "MD2024-1035",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "UT",
            "license": "12792806-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM LICENSE",
            "identifier": "MD2024-1035",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "D88188",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC LICENSE",
            "identifier": "MD047589",
            "state": "DC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/ Office Ally",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.