Individual provider Active NPI

Martin Yukpoon Tam, MD

  • Urology Physician
  • Salt Lake City, UT
National Provider Identifier
1932474079
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
8831907-1205 Issued in UT
Practice address
1002 E South Temple
Salt Lake City, UT 84102-1525
Phone
(801) 521-2102
Fax
(801) 521-2830
NPI assigned
Mar 21, 2012
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 8831907-1205 UT Primary

Addresses

Primary practice location

1002 E South Temple
Salt Lake City, UT 84102-1525

Mailing address

1002 E South Temple Ste 202
Salt Lake City, UT 84102-1564
Phone (801) 521-2102

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
I20170906000571 UT Practitioner - Urology 2567692742 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8831907-1205UTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Jul 26, 2017 Accepting new patients
University of Utah Adult Services CurrentSince Jul 26, 2017 Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1932474079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 E SOUTH TEMPLE STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021564",
            "telephone_number": "801-521-2102",
            "fax_number": "801-331-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E SOUTH TEMPLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021525",
            "telephone_number": "801-521-2102",
            "fax_number": "801-521-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "MARTIN",
        "middle_name": "YUKPOON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-21",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "8831907-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.