Individual provider Active NPI

Ryan B Nielsen, MD

  • Diagnostic Radiology Physician
  • Provo, UT
National Provider Identifier
1821032863
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4875352-1205 Issued in UT
Practice address
1034 N 500 W
Provo, UT 84604-3380
Phone
(801) 373-7850
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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 4875352-1205 UT Primary
Vascular & Interventional Radiology Physician 2085R0204X 4875352-1205 UT

Addresses

Primary practice location

1034 N 500 W
Provo, UT 84604-3380

Mailing address

560W 800 N
Orem, UT 84057-3746
Phone (801) 225-6246

Other identifiers 5

IdentifierTypeStateIssuer
107009643102OtherUTIHC
48753521202001OtherUTBLUE CROSS
692525OtherUTDMBA
870284448008MedicaidUT
870284448NRYOtherUTEMIA

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
I20040625000822 UT Practitioner - Radiation Oncology 4385628718 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Creighton University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Valley Radiology Associates IncGroup PAC ID 1759286990, 35 clinicians
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1055 N 300
Suite 308
Provo, UT 84604-3373
Phone (801) 379-6700

280 River Park Dr
Suite 120
Provo, UT 84604-5796
Phone (801) 229-2011

306 River Bend LN
Provo, UT 84604-5625
Phone (801) 226-5800

544 S 400
DRMC Physicians Billing
St George, UT 84770-3705
Phone (435) 688-4000

Hospital & facility affiliations

  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023
  • Park City Hospital Hospital, Park City, UT, CCN 460057
  • San Juan Hospital Hospital, Monticello, UT, CCN 461308
  • Intermountain Health Heber Valley Hospital Hospital, Heber City, UT, CCN 461307

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4875352-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tellica Imaging, LLC CurrentSince Jan 1, 2024 Accepting new patients
Bakorp, L.L.C. CurrentSince May 14, 2013 Accepting new patients
Ihc Health Services Inc CurrentSince Sep 15, 2009 Accepting new patients
St. George Radiology Inc. Diagnostic Radiology CurrentSince Dec 21, 2009 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Green River Radiology, P.C. Diagnostic Radiology CurrentSince Dec 15, 2021 Accepting new patients
Intermountain Vein Center Past Accepting new patients
Riverwoods Urgent Care Center LC PastSince Oct 6, 2003 Accepting new patients
Ubmc Anesthesiology PastSince Jul 1, 2020 Accepting new patients
Ihc Health Services Inc Diagnostic Radiology Past Accepting new patients

Locations

560 W 800 N
Orem, UT 84057
Phone (801) 701-6504

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

1000 N Main St
Richfield, UT 84701
Phone (435) 893-4100

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

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

1308 E 900 S
Ste C
St George, UT 84790
Phone (435) 673-2301

544 S 400 E
St George, UT 84770
Phone (435) 688-4000

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

190 Arrowhead Dr
Evanston, WY 82930
Phone (307) 789-3636

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15493/brand/1/csg/1/fhir/r4

Organizations & group practices 11

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.

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1821032863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560W 800 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840573746",
            "telephone_number": "801-225-6246",
            "fax_number": "801-225-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-373-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "RYAN",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "4875352-1205",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "UT",
            "license": "4875352-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC",
            "identifier": "107009643102",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "48753521202001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "692525",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870284448008",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMIA",
            "identifier": "870284448NRY",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.