Robert Hibbard, MD
Individual provider Active NPI Anesthesiology Physician · Salt Lake City, UT
NPI 1720185986 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1720185986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 318020-1205 (UT)
- Practice address
- 1200 E 3900 S
Salt Lake City, UT 84124-1300 - Phone
- (801) 993-9530
- Fax
- (801) 733-5618
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- University of Utah School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Millcreek Anesthesia PC
Practice addresses (Care Compare)
1200 E 3900
St Marks Hospital
Salt Lake City, UT 84124-1300
Phone (801) 268-7111
Hospital & facility affiliations
- St Mark'S Hospital
- Timpanogos Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101020000674 | UT | Practitioner - Anesthesiology | 7911190103 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 318020-1205 | UT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millcreek Anesthesia PC | Anesthesiology | Current |
Accepting new patients |
| Anesthesia Associates of Colorado Springs, P.C. | Anesthesiology | Past | Accepting new patients |
| Sevocation Anesthesia, PLLC | Anesthesiology | Past | Accepting new patients |
Locations
1200 E 3900 S
Slc, UT 84124
Phone (801) 268-7111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 318020-1205 | UT | Yes |
Addresses
Primary practice location
1200 E 3900 S
Salt Lake City, UT 84124-1300
Mailing address
1954 Fort Union Blvd
Salt Lake City, UT 84121-6800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93685 | Medicaid | UT | |
| QM0000046592 | Other | UT | ALTIUS |
| PRA04286 | Other | UT | MOLINA |
| 340473 | Other | UT | DESERET MUTUAL |
| 60548 | Other | UT | PEHP |
| 2000053 | Other | UT | UNITED HEALTHCARE |
| 107007094101 | Other | UT | IHC |
Other providers in Salt Lake City, UT
- Aaron D. Hezeltine
- Rebecca L. Hezeltine
- Jenny Hiatt
- Laurel Hiatt
- Virginia Hiatt
- John B Hibbs Jr.
- Ellen Grace Hibdon
- Kaleb Hibdon
- Dawn Michelle Hibl
- Anna Hicken
All providers in Salt Lake City, UT · Anesthesiology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.