Active NPI
Ryan B Nielsen, MD
- Diagnostic Radiology Physician
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 4875352-1205
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107009643102 | Other | UT | IHC |
| 48753521202001 | Other | UT | BLUE CROSS |
| 692525 | Other | UT | DMBA |
| 870284448008 | Medicaid | UT | |
| 870284448NRY | Other | UT | EMIA |
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
Enrollment records 1
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
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
- American Fork Hospital
- Park City Hospital
- San Juan Hospital
- Intermountain Health Heber Valley Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 12 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4875352-1205 | UT | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tellica Imaging, LLC | Current | Accepting new patients | |
| Bakorp, L.L.C. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| St. George Radiology Inc. | Diagnostic Radiology | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Green River Radiology, P.C. | Diagnostic Radiology | Current | Accepting new patients |
| Intermountain Vein Center | Past | Accepting new patients | |
| Riverwoods Urgent Care Center LC | Past | Accepting new patients | |
| Ubmc Anesthesiology | Past | 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
- 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.
-
- Multi-Specialty Clinic/Center
- Murray, UT
- NPI 1629260880
-
- Diagnostic Radiology Physician
- Provo, UT
- NPI 1265483598
-
- Diagnostic Radiology Physician
- Pleasant Grove, UT
- NPI 1508533878
-
- Diagnostic Radiology Physician
- St George, UT
- NPI 1790736130
-
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- West Valley, UT
- NPI 1023357894
-
- Multi-Specialty Clinic/Center
- Heber City, UT
- NPI 1720032865
-
- Physiological Laboratory
- Ogden, UT
- NPI 1144802802
-
- Diagnostic Radiology Physician
- Provo, UT
- NPI 1003291568
-
- Specialist
- Provo, UT
- NPI 1104959758
-
- Emergency Medicine Physician
- Provo, UT
- NPI 1801894035
-
- Certified Registered Nurse Anesthetist
- Roosevelt, UT
- NPI 1043643877
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Heber City, UT
- NPI 1316055205
-
- General Acute Care Hospital
- Park City, UT
- NPI 1851530984
-
- General Acute Care Hospital
- Provo, UT
- NPI 1114025491
-
- General Acute Care Hospital
- American Fork, UT
- NPI 1912014358
-
- Critical Access Hospital
- Monticello, UT
- NPI 1942251459
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.