Individual provider Active NPI

Mikio Obayashi, M.D.

  • Family Medicine Physician
  • Roy, UT
National Provider Identifier
1912923541
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
973396981205 Issued in UT
Practice address
1915 W 5950 S
Roy, UT 84067-1454
Phone
(801) 387-8100
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 973396981205 UT Primary

Addresses

Primary practice location

1915 W 5950 S
Roy, UT 84067-1454

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 387-8100

Other identifiers 1

IdentifierTypeStateIssuer
1053441873MedicaidUT

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080717000787 UT Practitioner - Family Practice 2466525878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services Inc 3,948 clinicians

Practice addresses (Care Compare)

1915 W 5950
Roy, UT 84067-1454
Phone (801) 387-8100

Hospital & facility affiliations

  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
973396981205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Aug 1, 1997 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Aug 1, 1997 Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1915 W 5950 S
Roy, UT 84067
Phone (801) 387-8100

Organizations & group practices 4

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 2

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1912923541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-387-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 W 5950 S",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840671454",
            "telephone_number": "801-387-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBAYASHI",
        "first_name": "MIKIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "973396981205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053441873",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roy, UT

Sources for this page

Verify at the official NPI Registry.