Imad S Farrukh, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

1786741205 Issued in UT

Practice address

3584 W 9000 S Ste 201
West Jordan, UT 84088-4773

Phone

(801) 568-0202

Fax

(801) 532-0906

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Pulmonary DiseaseAlso: Critical Care (Intensivists), Sleep Medicine

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051
• Intermountain Medical Center Hospital, Murray, UT, CCN 460010

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Utah Lung Center, LLC

  • Internal Medicine Physician
  • West Jordan, UT
  • NPI 1093923591

  Pulmonary Disease

  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  • General Acute Care Hospital
  • West Jordan, UT
  • NPI 1801591391
  Care Compare affiliation
• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1851498273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150173",
            "address_2": "ABS",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844150173",
            "telephone_number": "801-479-0601",
            "fax_number": "801-479-4768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3584 W 9000 S STE 201",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884773",
            "telephone_number": "801-568-0202",
            "fax_number": "801-532-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRUKH",
        "first_name": "IMAD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "UT",
            "license": "1786741205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Surgical Suite
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• Heston Farnsworth, D.M.D.
• McKala Farnsworth, LMT
• Kylie Farnworth
• Fernando Febres
• Nathan Fenn
• Ashleigh Fernandez
• Jennifer Fernelius
• Jillian Ferrell

• Pulmonary Disease Physician in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Pulmonary Disease Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.