NPIMap

Individual provider Active NPI

Kathleen Joanne Bartczak, M.D.

  • Family Medicine Physician
  • Moab, UT
National Provider Identifier
1649629445
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11772435-1205 Issued in UT
Practice address
450 Williams Way
Moab, UT 84532-2185
Phone
(435) 719-3500
NPI assigned
Jun 13, 2016
Last updated
Feb 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MRM-1546 ID
Family Medicine Physician 207Q00000X 11772435-1205 UT Primary

Addresses

Primary practice location

450 Williams Way
Moab, UT 84532-2185

Mailing address

450 Williams Way
Moab, UT 84532-2185
Phone (435) 719-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200930001201 UT Practitioner - Family Practice 9032402946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moab Valley Healthcare, Inc.Group PAC ID 2466361720, 18 clinicians

Practice addresses (Care Compare)

476 Williams Way
Moab, UT 84532-2186
Phone (435) 719-5500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Moab Valley Healthcare, Inc. CurrentSince Sep 1, 2020 Accepting new patients
Moab Valley Healthcare, Inc. CurrentSince Oct 6, 2025 Accepting new patients
Moab Valley Healthcare, Inc Family Medicine CurrentSince Sep 1, 2020 Accepting new patients

Locations

450 W Williams Way
Moab, UT 84532
Phone (435) 259-7191

476 W Williams Way
Moab, UT 84532
Phone (435) 719-3500

Interoperability endpoints

  • Direct secure messaging: kathleenb@mrhmoab.securechart.com

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 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": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1649629445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 WILLIAMS WAY",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322185",
            "telephone_number": "435-719-3500",
            "fax_number": "435-719-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WILLIAMS WAY",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "845322185",
            "telephone_number": "435-719-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTCZAK",
        "first_name": "KATHLEEN",
        "middle_name": "JOANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MRM-1546",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11772435-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moab, UT

Sources for this page

Verify at the official NPI Registry.