Individual provider Active NPI

Mark V Reichman, M.D.

  • Neurological Surgery Physician
  • Murray, UT
National Provider Identifier
1942260617
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
1732781205 Issued in UT
Practice address
5171 Cottonwood St
Suite 950
Murray, UT 84107-5704
Phone
(801) 507-9555
Fax
(801) 507-9550
NPI assigned
Mar 25, 2006
Last updated
Aug 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 1732781205 UT Primary

Addresses

Primary practice location

5171 Cottonwood St
Suite 950
Murray, UT 84107-5704

Mailing address

2191 E Pheasant Way
Holladay, UT 84121-1310
Phone (801) 403-3074

Other identifiers 1

IdentifierTypeStateIssuer
529903586002MedicaidUT

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
I20031117000689 UT Practitioner - Neurosurgery 4082528757 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1732781205UTMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Feb 1, 2008 Accepting new patients
Livecare Florida, P.a. Current Accepting new patients
Neurosurgical Associates LLC Neurological Surgery CurrentSince Jun 1, 2003 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Feb 1, 2008 Accepting new patients
Robert G Peterson, MD, PC Neurological Surgery Past Accepting new patients

Locations

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

900 Round Valley Dr
Ste 100
Park City, UT 84060
Phone (435) 655-6600

5171 S Cottonwood St
Ste 950
Salt Lake City, UT 84107
Phone (801) 507-9555

370 Ninth Ave
Ste 111
Salt Lake Cty, UT 84103
Phone (801) 408-2067

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

370 Ninth Ave
#111
Slc, UT 84103
Phone (801) 408-2067

301 N 200 E
#2B
St George, UT 84770
Phone (435) 652-8411

Organizations & group practices 6

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": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1942260617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 E PHEASANT WAY",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841211310",
            "telephone_number": "801-403-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 COTTONWOOD ST",
            "address_2": "SUITE 950",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075704",
            "telephone_number": "801-507-9555",
            "fax_number": "801-507-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICHMAN",
        "first_name": "MARK",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-25",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "UT",
            "license": "1732781205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529903586002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.