Individual provider Active NPI

Steven J Souza, M.D.

  • Vascular & Interventional Radiology Physician
  • Murray, UT
National Provider Identifier
1770523854
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
370006-1205 Issued in UT
Practice address
5444 Green St
Murray, UT 84123-5632
Phone
(801) 262-8120
Fax
(801) 262-5721
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 370006-1205 UT
Vascular & Interventional Radiology Physician 2085R0204X 370006-1205 UT Primary
Diagnostic Radiology Physician 2085R0202X M-8452 ID

Addresses

Primary practice location

5444 Green St
Murray, UT 84123-5632

Mailing address

5444 Green St
Murray, UT 84123-5632
Phone (801) 262-2647

Other identifiers 1

IdentifierTypeStateIssuer
D6205MedicaidUT

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
I20040206000264 UT Practitioner - Diagnostic Radiology 5395638985 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-8452IDMDDiagnostic Radiology Physician
370006-1205UTMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Medical Physician Specialists PC Diagnostic Radiology CurrentSince Jun 1, 1999 Accepting new patients
Ocala Orthopaedic Group PA Past Accepting new patients

Locations

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

355 N Main St
Kanab, UT 84741
Phone (435) 644-4100

5323 S Woodrow St
Salt Lake City, UT 84107
Phone (801) 261-8346

5444 S Green St
Salt Lake City, UT 84123
Phone (801) 262-2647

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1770523854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 GREEN ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-2647",
            "fax_number": "801-262-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5444 GREEN ST",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-8120",
            "fax_number": "801-262-5721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "370006-1205",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "370006-1205",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-8452",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D6205",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.