NPIMap

Individual provider Active NPI

Samuel T. Keane, MD

  • Diagnostic Radiology Physician
  • Murray, UT
National Provider Identifier
1801459037
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
11956943-1205 Issued in UT
Practice address
5295 S Commerce Dr Ste 550
Murray, UT 84107-4736
Phone
(801) 313-4110
NPI assigned
Apr 14, 2019
Last updated
Nov 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 11956943-1205 UT Primary

Addresses

Primary practice location

5295 S Commerce Dr Ste 550
Murray, UT 84107-4736

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Other practice location 1

30 N 1900 E Rm 1A071
Salt Lake City, UT 84132-0002
Phone (801) 581-2868

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC/ Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241010003232 UT Practitioner - Diagnostic Radiology 6507285152 Reassigns benefits to 3 organizations
I20260302002861 WA Practitioner - Diagnostic Radiology 6507285152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uintah Basin Medical CenterGroup PAC ID 0244131944, 62 clinicians
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

250 W 300
75 2
Roosevelt, UT 84066-2336
Phone (435) 722-4691

5295 S Commerce Dr
Suite 550
Murray, UT 84107-4736
Phone (801) 313-4110

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11956943-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Tellica Imaging, LLC CurrentSince Jul 1, 2025 Accepting new patients
Tellica Imaging, LLC CurrentSince Jul 1, 2025 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology CurrentSince Feb 13, 2026 Accepting new patients
Uintah Basin Medical Center CurrentSince Oct 2, 2024 Accepting new patients
Tellica Imaging, LLC CurrentSince Jun 5, 2025 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Tellica Imaging, LLC CurrentSince Jul 1, 2025 Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Jun 5, 2025 Accepting new patients
Ihc Health Services Inc CurrentSince Jul 1, 2025 Accepting new patients
Uintah Basin Medical Center CurrentSince Oct 2, 2024 Accepting new patients

Locations

250 W 300 N
#752
Roosevelt, UT 84066
Phone (435) 722-4691

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

5295 S Commerce Dr
Ste 550
Salt Lake City, UT 84107
Phone (801) 313-4110

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

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479

Interoperability endpoints

  • Direct secure messaging: skeane419765@direct.vumc.org

Organizations & group practices 12

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 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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1801459037",
    "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": "5295 S COMMERCE DR STE 550",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074736",
            "telephone_number": "801-313-4110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 N 1900 E Rm 1A071",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320002",
            "country_code": "US",
            "telephone_number": "801-581-2868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEANE",
        "first_name": "SAMUEL",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "11956943-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/ Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.