NPIMap

Individual provider Active NPI

Mana Espahbodi, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Salt Lake City, UT
National Provider Identifier
1659735249
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
12792745-1205 Issued in UT
Practice address
50 N Medical Dr Som 3C120
Salt Lake City, UT 84132-0001
Phone
(801) 662-5663
NPI assigned
Apr 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D90995 MD
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X 12792745-1205 UT Primary

Addresses

Primary practice location

50 N Medical Dr Som 3C120
Salt Lake City, UT 84132-0001

Mailing address

50 N Medical Dr Som 3C120
Salt Lake City, UT 84132-0001
Phone (801) 662-5663

Other practice location 1

601 N Caroline St # Street6
Baltimore, MD 21287-0006
Phone (410) 955-1559

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MESPAHBODI580191@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, UT2 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
I20210603001020 MD Practitioner - Otolaryngology 4082978457 Reassigns benefits to 1 organization
I20220609000163 UT Practitioner - Otolaryngology 4082978457 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Vanderbilt University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009
  • St Johns Medical Center Hospital, Jackson, WY, CCN 530015

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince May 1, 2022 Accepting new patients
University of Utah Pediatric Services CurrentSince May 1, 2022 Accepting new patients
Johns Hopkins University CurrentSince Jul 1, 2021 Accepting new patients
University of Utah Adult Services CurrentSince May 1, 2022 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Johns Hopkins University Otolaryngology CurrentSince Jul 1, 2021 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince May 1, 2022 Accepting new patients
Johns Hopkins University Current Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
University of Utah Pediatric Services Past Accepting new patients

Locations

600 N Wolfe St
Baltimore, MD 21287

601 N Caroline St
#6
Baltimore, MD 21287
Phone (410) 955-7808

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

8322 Bellona Ave
Ste 300
Towson, MD 21204
Phone (410) 296-0414

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

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

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

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

Interoperability endpoints

  • Direct secure messaging: mespahbodi841460@direct.hopkinsmedicine.org
  • Direct secure messaging: mespahbodi580191@direct.med.utah.edu

Organizations & group practices 11

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 4

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": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1659735249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR SOM 3C120",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-662-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR SOM 3C120",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-662-5663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 N Caroline St # Street6",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870006",
            "country_code": "US",
            "telephone_number": "410-955-1559",
            "fax_number": "410-367-2244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESPAHBODI",
        "first_name": "MANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-08",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D90995",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "UT",
            "license": "12792745-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MESPAHBODI580191@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 Som 3C120",
            "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.