NPIMap

Individual provider Active NPI

Blake A. Bartholomew, MD

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
National Provider Identifier
1619539749
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11885469-1205 Issued in UT
Practice address
30 N 1900 E RM 1A071
Salt Lake City, UT 84132-0002
Phone
(801) 581-2868
NPI assigned
Jun 28, 2019
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4351045622 MI
Diagnostic Radiology Physician 2085R0202X 11885469-1205 UT Primary

Addresses

Primary practice location

30 N 1900 E RM 1A071
Salt Lake City, UT 84132-0002

Mailing address

30 N 1900 E RM 1A071
Salt Lake City, UT 84132-0002
Phone (801) 581-2868

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bbartholomew439870@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WA2 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
I20240712001772 UT Practitioner - Diagnostic Radiology 8123356037 Reassigns benefits to 4 organizations
I20260302000891 WA Practitioner - Diagnostic Radiology 8123356037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uintah Basin Medical CenterGroup PAC ID 0244131944, 62 clinicians
Tellica Imaging - Washington LLCGroup PAC ID 0648757393, 50 clinicians
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

250 W 300
75 2
Roosevelt, UT 84066-2336
Phone (435) 722-4691

2941 S 38TH St
Suite E
Tacoma, WA 98409-5647
Phone (253) 534-8689

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-6387

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

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jun 1, 2025 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Tellica Imaging, LLC CurrentSince Jul 1, 2025 Accepting new patients
Tellica Imaging, LLC CurrentSince Jul 1, 2025 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology CurrentSince Feb 6, 2026 Accepting new patients
Uintah Basin Medical Center CurrentSince Aug 1, 2024 Accepting new patients
Tellica Imaging, LLC CurrentSince Jul 1, 2025 Accepting new patients
University of Utah Adult Services Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Ihc Health Services Inc Internal Medicine Current Accepting new patients
Tellica Imaging, LLC CurrentSince Jul 1, 2025 Accepting new patients
Ihc Health Services Inc CurrentSince Jun 1, 2025 Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Uintah Basin Medical Center CurrentSince Aug 1, 2024 Accepting new patients
University of Utah Adult Services CurrentSince Jun 1, 2024 Accepting new patients

Locations

250 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

250 W 300 N
#752
Roosevelt, UT 84066
Phone (435) 722-4691

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

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

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

405 N 500 W
Vernal, UT 84078
Phone (435) 781-2335

Interoperability endpoints

  • Direct secure messaging: bbartholomew439870@direct.med.utah.edu

Organizations & group practices 15

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.

View all 15

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": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1619539749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 1A071",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 1A071",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTHOLOMEW",
        "first_name": "BLAKE",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-28",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4351045622",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "11885469-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbartholomew439870@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.