Individual provider Active NPI

Thomas G Rogers, D.P.M.

  • Podiatrist
  • Provo, UT
National Provider Identifier
1720069446
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
103496-0501 Issued in UT
Practice address
150 W 800 N
Provo, UT 84601-1624
Phone
(801) 375-5353
Fax
(801) 375-5395
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 103496-0501 UT Primary

Addresses

Primary practice location

150 W 800 N
Provo, UT 84601-1624

Mailing address

150 W 800 N
Provo, UT 84601-1624
Phone (801) 375-5353

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051220000359 UT Practitioner - Podiatry 1759303647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Utah Foot Clinic, LLCGroup PAC ID 2264517101, 2 clinicians

Practice addresses (Care Compare)

150 W 800
Provo, UT 84601-1624
Phone (801) 375-5353

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103496-0501UTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Utah Foot Clinic, LLC Podiatrist CurrentSince Apr 1, 2008 Accepting new patients
Utah State Developmental Center CurrentSince Mar 10, 2015 Accepting new patients
State of Utah CurrentSince Mar 10, 2015 Accepting new patients

Locations

895 N 900 E
American Fork, UT 84003
Phone (801) 756-6022

150 W 800 N
Provo, UT 84601
Phone (801) 375-5353

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1720069446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W 800 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011624",
            "telephone_number": "801-375-5353",
            "fax_number": "801-375-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W 800 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011624",
            "telephone_number": "801-375-5353",
            "fax_number": "801-375-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "THOMAS",
        "middle_name": "G",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "UT",
            "license": "103496-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.