Samuel John Kozloff, M.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

11942247-1205 Issued in UT

Practice address

630 Medical Dr
Bountiful, UT 84010-4908

Phone

(775) 204-1400

NPI assigned

Apr 11, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

89.77 of 100Reported as group

Quality

91.47

Promoting interoperability

100

Improvement activities

40

Cost

74.42

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (9 of 13)

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: skozloff677942@nychhc.direct-ci.com
• Direct secure messaging: skozloff@yourcarecommunity.org
• Direct secure messaging: samuel.kozloff@297228672368644.direct.elationemr.com
• Direct secure messaging: skozloff547870@direct.med.utah.edu

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.

• Tooele Clinic Corp

  • Family Medicine Physician
  • Tooele, UT
  • NPI 1073512364

  Internal Medicine, UT

  Medicare reassignment NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981

  UT

  Medicare reassignment NPD
• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Murray, UT
  • NPI 1962821223

  Hospitalist, UT

  Medicare reassignment NPD
• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  Internal Medicine, NY

  Medicare reassignment NPD
• University of Utah Adult Services

  • Urology Physician
  • Salt Lake City, UT
  • NPI 1356745160
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613

  Internal Medicine

  NPD
• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Idaho Falls, ID
  • NPI 1740715507

  Hospitalist

  NPD
• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • New York, NY
  • NPI 1073535027

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1821521337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MEDICAL DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104908",
            "telephone_number": "775-204-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "212-263-5506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOZLOFF",
        "first_name": "SAMUEL",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-11",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "11942247-1205",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "11942247-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skozloff547870@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James D Knight, D.C.
• Duane Knowles, OD
• Alisa Ann Knowlton, MD
• Sabine Koepf-Shakib, M.D.
• Anyelina Kone
• Skylar Kramer
• Marilou Miner Krstyen, RPH
• Ellison M Kruckenberg, COTA/L
• James Krumholz, PT, DPT
• Taylor Marie Krupp, PA-C

• All providers in Bountiful, UT
• Hospitalist Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.

Verify at the official NPI Registry.