Mark N. F. Massoud, MBCHB

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

12240898-1205 Issued in UT

Practice address

30 N 1900 E RM 4R312
Salt Lake City, UT 84132-0002

Phone

(801) 581-8193

NPI assigned

Jun 25, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Nephrology

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Medical Center Hospital, Murray, UT, CCN 460010
• Intermountain Health Riverton Hospital Hospital, Riverton, UT, CCN 460058
• LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
• Intermountain Health Alta View Hospital Hospital, Sandy, UT, CCN 460044
• Park City Hospital Hospital, Park City, UT, CCN 460057

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: markmassoud@sfc.allscriptsdirect.net

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  dba Cardiac Imaging - Mt Pleasant

  • Cardiovascular Disease Physician
  • Mt Pleasant, UT
  • NPI 1396990883
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Springfield Clinic LLP

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1215974415
  NPD
• Ihc Health Services Inc

  dba Orem Community Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

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

• Ihc Health Services Inc

  dba Intermountain Health Riverton Hospital

  • General Acute Care Hospital
  • Riverton, UT
  • NPI 1154551919
  Care Compare affiliation
• Ihc Health Services Inc

  dba Intermountain Health Park City Hospital

  • General Acute Care Hospital
  • Park City, UT
  • NPI 1851530984
  Care Compare affiliation
• Ihc Health Services Inc

  dba Intermountain Health Alta View Hospital

  • General Acute Care Hospital
  • Sandy, UT
  • NPI 1962412486
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Intermountain Medical Center

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health LDS Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1528078581
  Care Compare affiliation

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1881009157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 4R312",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 4R312",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-8193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627023757",
            "country_code": "US",
            "telephone_number": "217-545-0182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSOUD",
        "first_name": "MARK",
        "middle_name": "N. F.",
        "credential": "MBCHB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125065612",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "UT",
            "license": "12240898-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "markmassoud@sfc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "701 N 1st St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627023757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Nicole Massey
• David Massey, OT
• Shontai Massey
• Jessie Massicotte
• Sharon D Massinople, PAC
• Alan R. Massouh, MD
• Samuel Mastel, DO
• Master Lu's Health Center
• Mastermind Behavior Services Ut LLC
• Brittany Ellen Masterson, NP

• Nephrology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Nephrology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.