Active NPI
Jorge Cesar Isaac, M.D,
- Anatomic Pathology & Clinical Pathology Physician
- Salt Lake City, UT
National Provider Identifier
1659476463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 374897-1205
- Practice address
- 360 E 4500 S
# 4
Salt Lake City, UT 84107-3992 - Phone
- (801) 266-0055
- Fax
- (801) 266-0056
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 374897-1205 | UT | Primary |
Addresses
Primary practice location
360 E 4500 S
# 4
Salt Lake City, UT 84107-3992
Mailing address
753 Johnnie Dodds Blvd
Mt Pleasant, SC 29464-3054
Phone (843) 284-3400
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 374897-1205 | Other | UT | UT MEDICAL LICENSE |
| MD.12025R | Other | LA | LA MEDICAL LICENSE # |
| ME77122 | Other | FL | FL MEDICAL LICENSE # |
| 00018771 | Other | AL | AL MEDICAL LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 374897-1205 | UT | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659476463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "753 JOHNNIE DODDS BLVD",
"city": "MT PLEASANT",
"state": "SC",
"postal_code": "294643054",
"telephone_number": "843-284-3400",
"fax_number": "843-284-3401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 E 4500 S",
"address_2": "# 4",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841073992",
"telephone_number": "801-266-0055",
"fax_number": "801-266-0056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISAAC",
"first_name": "JORGE",
"middle_name": "CESAR",
"name_prefix": "Dr.",
"credential": "M.D,",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "UT",
"license": "374897-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UT MEDICAL LICENSE",
"identifier": "374897-1205",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA MEDICAL LICENSE #",
"identifier": "MD.12025R",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL MEDICAL LICENSE #",
"identifier": "ME77122",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AL MEDICAL LICENSE #",
"identifier": "00018771",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.