Individual provider Active NPI

Thomas K Trauba

  • Pain Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1891793147
Registry record updated May 5, 2008
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(4) exclusion effective Feb 18, 2016.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
174956-1205 Issued in UT
Practice address
3838 S 700 E
Salt Lake City, UT 84106-1496
Phone
(801) 261-4988
Fax
(801) 269-9427
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 174956-1205 UT Primary

Addresses

Primary practice location

3838 S 700 E
Salt Lake City, UT 84106-1496

Mailing address

PO Box 27688
Salt Lake City, UT 84127-0688
Phone (801) 534-1360

Other identifiers 1

IdentifierTypeStateIssuer
D2438MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
174956-1205UTMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Omega Interventional Pain PLLC Pain Medicine Past Accepting new patients
Lifetree Medical Inc Pain Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209945600000",
    "number": "1891793147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27688",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270688",
            "telephone_number": "801-534-1360",
            "fax_number": "801-366-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 S 700 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841061496",
            "telephone_number": "801-261-4988",
            "fax_number": "801-269-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUBA",
        "first_name": "THOMAS",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2008-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "UT",
            "license": "174956-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D2438",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.