NPIMap

Organization Active NPI

Daniel R Cottam MD PC

Doing business as Provider Surgical Services

  • Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1871030742
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
DANIEL R COTTAM MD PC
Doing business as
Provider Surgical Services
Practice address
1046 E 100 S
Suite 400
Salt Lake City, UT 84102-1520
Phone
(801) 746-2885
Fax
(801) 746-2886
NPI assigned
Jan 30, 2017
Last updated
Jan 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Daniel R Cottam, MDNPI 1760574776
Title
Owner
Phone
(801) 523-0305

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

1046 E 100 S
Suite 400
Salt Lake City, UT 84102-1520

Mailing address

1046 E 100 S
Suite 400
Salt Lake City, UT 84102-1520
Phone (801) 746-2885

Other names 1

  • Provider Surgical Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170718000843 UT Part B Supplier - Clinic/Group Practice 6800166299 Receives reassigned benefits from 4 practitioners
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory

Locations

1046 E 100 S
Ste 400
Salt Lake Cty, UT 84102
Phone (801) 746-2885

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1871030742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 E 100 S",
            "address_2": "SUITE 400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021520",
            "telephone_number": "801-746-2885",
            "fax_number": "801-746-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 E 100 S",
            "address_2": "SUITE 400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021520",
            "telephone_number": "801-746-2885",
            "fax_number": "801-746-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL R COTTAM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-30",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "COTTAM",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-523-0305",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provider Surgical Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Provider Surgical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.