Individual provider Active NPI

Thomas Cary Wilson, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Salt Lake City, UT
National Provider Identifier
1891922951
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
5304262-1205 Issued in UT
Practice address
5330 S 900 E Ste 120
Salt Lake City, UT 84117-3504
Phone
(801) 266-0055
Fax
(801) 266-0056
NPI assigned
Jun 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 40720 IA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 5304262-1205 UT Primary

Addresses

Primary practice location

5330 S 900 E Ste 120
Salt Lake City, UT 84117-3504

Mailing address

5330 S 900 E Ste 120
Salt Lake City, UT 84117-3504
Phone (801) 266-0055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150708001594 IL Practitioner - Pathology 5698918688 Reassigns benefits to 1 organization
I20201230002193 UT Practitioner - Pathology 5698918688 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Pathology Services IncGroup PAC ID 1355251521, 28 clinicians

Practice addresses (Care Compare)

Provo, UT 84604
Phone (801) 266-0055

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-7850

1400 N 500
Logan, UT 84341-2455
Phone (435) 716-1000

170 N 1100
American Fork, UT 84003-2096
Phone (801) 855-3300

3741 W 12600
Riverton, UT 84065-7215
Phone (801) 266-0055

5252 S Intermountain Dr
Murray, UT 84107-5700
Phone (801) 266-0055

765 E Marker Place Dr
Spanish Fork, UT 84660-1396
Phone (385) 344-5000

8 TH Ave and C St
Salt Lake City, UT 84143-0001
Phone (801) 266-0055

900 Round Valley Dr
Park City, UT 84060-7552
Phone (801) 266-0055

9660 S 1300
Sandy, UT 84094-3762
Phone (801) 266-0055

Hospital & facility affiliations

  • Intermountain Medical Center Hospital, Murray, UT, CCN 460010
  • St. George Regional Hospital Hospital, St George, UT, CCN 460021
  • LDS Hospital Hospital, Salt Lake City, UT, CCN 460006
  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

Merit-based Incentive Payment System (MIPS)

Final score
88.42 of 100Reported as group
Quality
86.38
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Pathology Services, Inc Anatomic Pathology & Clinical Pathology CurrentSince Jan 1, 2021 Accepting new patients
Winfield Pathology Consultants, S.C. CurrentSince Jul 1, 2015 Accepting new patients

Locations

Dept 4432
Carol Stream, IL 60122

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

5700 Southwyck Blvd
Toledo, OH 43614

5330 S 900 E
Ste 120
Murray, UT 84117
Phone (801) 631-8769

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

5252 S Intermountain Dr
Salt Lake City, UT 84107
Phone (801) 507-2110

8th Ave C St
Salt Lake City, UT 84143
Phone (801) 269-2500

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1891922951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5330 S 900 E STE 120",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841173504",
            "telephone_number": "801-266-0055",
            "fax_number": "801-266-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 S 900 E STE 120",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841173504",
            "telephone_number": "801-266-0055",
            "fax_number": "801-266-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "THOMAS",
        "middle_name": "CARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IA",
            "license": "40720",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "UT",
            "license": "5304262-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.