Individual provider Active NPI

Robert P Smilanich, MD

  • Vascular Surgery Physician
  • Provo, UT
National Provider Identifier
1730187600
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
3089384-1205 Issued in UT
Practice address
1055 N 300 W
Suite 205
Provo, UT 84604-3374
Phone
(801) 374-9100
Fax
(801) 374-9117
NPI assigned
Jul 13, 2005
Last updated
Feb 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 3089384-1205 UT Primary

Addresses

Primary practice location

1055 N 300 W
Suite 205
Provo, UT 84604-3374

Mailing address

1055 N 300 W
Suite 205
Provo, UT 84604-3374
Phone (801) 374-9100

Other identifiers 3

IdentifierTypeStateIssuer
638375OtherUTDMBA
870656925SM1OtherUTEMIA
30893841201001OtherUTBLUE CROSS

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
I20100212000112 UT Practitioner - Vascular Surgery 4486684222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
George Washington University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-8879

1303 N Main St
Cedar City, UT 84721-9746

395 W Bulldog Blvd
Provo, UT 84604-3323

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

98 N 1100
American Fork, UT 84003-2947

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)19
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3089384-1205UTMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2012 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 1, 2012 Accepting new patients
Utah Vascular Center CurrentSince Mar 25, 2000 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1055 N 300 W
Ste 205
Provo, UT 84604
Phone (801) 374-9100

395 W Cougar Blvd
Ste 503
Provo, UT 84604
Phone (801) 357-4600

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392249600000",
    "number": "1730187600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 300 W",
            "address_2": "SUITE 205",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043374",
            "telephone_number": "801-374-9100",
            "fax_number": "801-374-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N 300 W",
            "address_2": "SUITE 205",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043374",
            "telephone_number": "801-374-9100",
            "fax_number": "801-374-9117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILANICH",
        "first_name": "ROBERT",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2014-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "UT",
            "license": "3089384-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "638375",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMIA",
            "identifier": "870656925SM1",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "30893841201001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.