Individual provider Active NPI

Mark B Shah, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Murray, UT
National Provider Identifier
1760405526
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
6125332-1205 Issued in UT
Practice address
5770 Fashion Blvd
Murray, UT 84107-6548
Phone
(801) 269-2500
Fax
(801) 269-2690
NPI assigned
Jul 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 6125332-1205 UT Primary

Addresses

Primary practice location

5770 Fashion Blvd
Murray, UT 84107-6548

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180
Phone (801) 269-2500

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
I20080220000439 UT Practitioner - Emergency Medicine 6800700832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Wisconsin School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Emergency PhysiciansGroup PAC ID 1153307277, 151 clinicians

Practice addresses (Care Compare)

5121 S Cottonwood St
Salt Lake City, UT 84107-5701
Phone (801) 507-9700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.98 of 100Reported as group
Quality
85.2
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Emergency Physicians Emergency Medicine CurrentSince Nov 1, 2019 Accepting new patients

Locations

3741 W 12600 S
Riverton, UT 84065
Phone (801) 285-2400

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

Organizations & group practices 1

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760405526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30180",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300180",
            "telephone_number": "801-269-2500",
            "fax_number": "801-269-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 FASHION BLVD",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076548",
            "telephone_number": "801-269-2500",
            "fax_number": "801-269-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MARK",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "6125332-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.