NPIMap

Individual provider Active NPI

James Gerald Carlisle, MD

  • Vascular & Interventional Radiology Physician
  • Farmington, UT
National Provider Identifier
1750478707
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
5617957-1205 Issued in UT
Practice address
1433 N 1075 W Ste 104
Farmington, UT 84025-2746
Phone
(801) 298-1300
Fax
(801) 296-6199
NPI assigned
Oct 9, 2006
Last updated
May 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 5617957-1205 UT
Vascular & Interventional Radiology Physician 2085R0204X 5617957-1205 UT Primary

Addresses

Primary practice location

1433 N 1075 W Ste 104
Farmington, UT 84025-2746

Mailing address

PO Box 25488
Salt Lake City, UT 84125-0488
Phone (800) 475-3698

Other practice location 1

3702 S State St Ste 103
South Salt Lake, UT 84115-5096
Phone (801) 281-0027

Other identifiers 7

IdentifierTypeStateIssuer
1750478707MedicaidUT
P00808370OtherUTRR MEDICARE
56179571211001OtherUTBCBSUT
56179571210001OtherUTBCBSUT
P00808365OtherUTRR MEDICARE
107031591105OtherUTSELECTHEALTH
847597OtherUTDMBA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040526001602 UT Practitioner - Interventional RadiologyPractitioner - Interventional Pain ManagementPractitioner - Diagnostic Radiology 0840271771 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of Michigan Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green River Radiology PCGroup PAC ID 5294123063, 23 clinicians
Tooele Valley Imaging LLCGroup PAC ID 2466624630, 24 clinicians
Wasatch Vascular Center LLCGroup PAC ID 1951726967, 6 clinicians
Utah Imaging Associates IncGroup PAC ID 1355394537, 45 clinicians

Practice addresses (Care Compare)

12842 S 3600
Suite 100
Riverton, UT 84065-6853
Phone (385) 253-4586

2356 N 400
Suite 103
Tooele, UT 84074-3409
Phone (435) 882-1674

3702 S State St
Suite 103
South Salt Lake, UT 84115-5096
Phone (801) 281-0027

6243 S Redwood Rd
Suite 130
Taylorsville, UT 84123-6408
Phone (801) 869-5630

630 Medical Dr
Bountiful, UT 84010-4908
Phone (801) 299-2220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.06 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.86

Merit-based Incentive Payment System (MIPS)

Final score
54.26 of 100Reported as group
Quality
56.16
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5617957-1205UTMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Green River Radiology, P.C. Diagnostic Radiology CurrentSince Dec 15, 2021 Accepting new patients
Wasatch Vascular Center LLC Vascular & Interventional Radiology CurrentSince Jul 1, 2020 Accepting new patients
Wasatch Imaging LLC CurrentSince Sep 15, 2024 Accepting new patients
Tooele Valley Imaging, LLC CurrentSince Oct 1, 2020 Accepting new patients
West Valley Imaging LLC Diagnostic Radiology Past Accepting new patients
Wasatch Vascular Center ASC LLC PastSince Jul 1, 2020 Accepting new patients
Ogden Imaging LLC Diagnostic Radiology Past Accepting new patients
Perspective Counseling Services LLC PastSince Dec 1, 2025 Accepting new patients
Utah Imaging Centers LLC Past Accepting new patients
Reflections Breast Health Center Diagnostic Radiology Past Accepting new patients
Reflections Breast Health Center Diagnostic Radiology Past Accepting new patients
Scott E Southworth MD PC Past Accepting new patients

Locations

2310 N 400 E
Ste F
Logan, UT 84341
Phone (435) 258-9598

12842 S 3600 W
Ste 100
Riverton, UT 84065
Phone (385) 253-4586

9844 S 1300 E
Ste 175
Sandy, UT 84094
Phone (801) 576-1290

3702 S State St
Ste 103
South Salt Lake, UT 84115
Phone (801) 281-0027

3702 S State St
Ste 105
South Salt Lake, UT 84115

3702 S State St
Ste 111
South Salt Lake, UT 84115
Phone (801) 281-0027

6243 S Redwood Rd
Ste 130
Taylorsville, UT 84123
Phone (801) 288-9671

2356 N 400 E
Ste 103
Tooele, UT 84074
Phone (435) 882-1674

Interoperability endpoints

  • Direct secure messaging: james.carlisle.d1.p122@direct.aac.nextgenshare.com
  • Direct secure messaging: james.carlisle.p117@direct.aac.nextgenshare.com
  • Direct secure messaging: james.carlisle.p121@direct.aac.nextgenshare.com
  • Direct secure messaging: james.carlisle.p186@direct.aac.nextgenshare.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1750478707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25488",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250488",
            "telephone_number": "800-475-3698",
            "fax_number": "801-296-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 N 1075 W STE 104",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252746",
            "telephone_number": "801-298-1300",
            "fax_number": "801-296-6199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3702 S State St Ste 103",
            "address_purpose": "LOCATION",
            "city": "South Salt Lake",
            "state": "UT",
            "postal_code": "841155096",
            "country_code": "US",
            "telephone_number": "801-281-0027",
            "fax_number": "801-262-1533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "JAMES",
        "middle_name": "GERALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "5617957-1205",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "5617957-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750478707",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00808370",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSUT",
            "identifier": "56179571211001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSUT",
            "identifier": "56179571210001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00808365",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECTHEALTH",
            "identifier": "107031591105",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "847597",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, UT

Sources for this page

Verify at the official NPI Registry.