Individual provider Active NPI

Kevin Conrad, MD

  • Anesthesiology Physician
  • Salt Lake City, UT
National Provider Identifier
1649666264
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
10098671-1205 Issued in UT
Practice address
30 N 1900 E Room 3C444
Salt Lake City, UT 84132
Phone
(801) 581-6393
Fax
(801) 581-4367
NPI assigned
Apr 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 10098671-1205 UT Primary

Addresses

Primary practice location

30 N 1900 E Room 3C444
Salt Lake City, UT 84132

Mailing address

30 N 1900 E Room 3C444 Som
Salt Lake City, UT 84132-2501
Phone (801) 581-6393

Other practice location 1

500 W Fort St # 111R
Boise VAMC
Boise, ID 83702-4501
Phone (208) 422-1314

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kconrad199670@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20190508000955 UT Practitioner - Anesthesiology 9234441833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Washington School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

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

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
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Apr 3, 2019 Accepting new patients
University of Utah Adult Services CurrentSince Apr 3, 2019 Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

30 N 1900 E
Rm 3C444
Slc, UT 84132
Phone (801) 581-3622

Interoperability endpoints

  • Direct secure messaging: kconrad199670@direct.med.utah.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1649666264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E ROOM 3C444 SOM",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841322501",
            "telephone_number": "801-581-6393",
            "fax_number": "801-581-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E ROOM 3C444",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84132",
            "telephone_number": "801-581-6393",
            "fax_number": "801-581-4367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Fort St # 111R",
            "address_2": "Boise VAMC",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837024501",
            "country_code": "US",
            "telephone_number": "208-422-1314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "10098671-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kconrad199670@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.