Individual provider Active NPI

Elizabeth Lane Ryals, M.D.

  • Pediatric Radiology Physician
  • Salt Lake City, UT
National Provider Identifier
1750701033
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
9560138-1205 Issued in UT
Practice address
100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone
(801) 662-1800
NPI assigned
Apr 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 9560138-1205 UT Primary
Diagnostic Radiology Physician 2085R0202X 9560138-1205 UT

Addresses

Primary practice location

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200805000662 TX Practitioner - Diagnostic Radiology 3072815695 Reassigns benefits to 1 organization
I20210907000754 UT Practitioner - Diagnostic Radiology 3072815695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2014
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)

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 487-0451

Hospital & facility affiliations

  • Primary Children'S Hospital Hospital, Salt Lake City, UT, CCN 463301

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9560138-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 12, 2024 Accepting new patients
Ihc Health Services Inc CurrentSince Jul 17, 2021 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Dec 31, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Nov 9, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jul 17, 2021 Accepting new patients
Tellica Imaging, LLC CurrentSince May 15, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince May 15, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince May 15, 2023 Accepting new patients
Tellica Imaging, LLC CurrentSince Dec 31, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2020 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 1, 2020 Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

2350 N Stemmons Fwy
Dallas, TX 75207
Phone (469) 488-7100

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

3621 22nd St
Ste 400
Lubbock, TX 79410
Phone (806) 791-8484

3030 Waterview Pkwy
Richardson, TX 75080
Phone (972) 669-7070

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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

5217 S State St
Ste 200
Salt Lake City, UT 84107
Phone (208) 417-5100

36 S Street St
Ste 2200
Salt Lake Cty, UT 84111
Phone (385) 622-0669

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

Interoperability endpoints

  • Direct secure messaging: eryals110163@direct.phhs.org

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 and National Provider Directory roles.

View all 13

Hospital & facility affiliations 1

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": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1750701033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYALS",
        "first_name": "ELIZABETH",
        "middle_name": "LANE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "UT",
            "license": "9560138-1205",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "9560138-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.