NPIMap

Individual provider Active NPI

Theodore S Paisley, MD

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1952415556
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4803526-1205 Issued in UT
Practice address
555 Foothill Dr
Salt Lake City, UT 84112-1106
Phone
(801) 581-8000
NPI assigned
Aug 19, 2006
Last updated
Nov 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4803526-1205 UT Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 4803526-1205 UT

Addresses

Primary practice location

555 Foothill Dr
Salt Lake City, UT 84112-1106

Mailing address

PO Box 510004
Salt Lake City, UT 84151-0004
Phone (801) 587-6600

Other identifiers 1

IdentifierTypeStateIssuer
P00418797OtherUTRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tpaisley3312@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050119000262 UT Practitioner - Family Practice 3072562826 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

1525 W 2100
Salt Lake City, UT 84119-1407
Phone (801) 213-9900

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone (801) 587-7109

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Merit-based Incentive Payment System (MIPS)

Final score
89.01 of 100Reported as group
Quality
94.06
Promoting interoperability
100
Improvement activities
40
Cost
69.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4803526-1205UTMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Family Medicine CurrentSince Jan 11, 2010 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 11, 2010 Accepting new patients
University of Utah Community Physicians Group Family Medicine Current Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Community Physicians Group CurrentSince Aug 27, 2018 Accepting new patients
University of Utah Community Physicians Group Family Medicine CurrentSince Aug 27, 2018 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Ihc Health Services Inc Family Medicine CurrentSince Nov 13, 2011 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Bronson Lakeview Hospital Family Medicine Past Accepting new patients

Locations

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

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

1138 E Wilmington Ave
Slc, UT 84106
Phone (801) 581-2000

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

555 Foothill Dr
Slc, UT 84112
Phone (801) 581-7589

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Interoperability endpoints

  • Direct secure messaging: tpaisley3312@direct.med.utah.edu

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1952415556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510004",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841510004",
            "telephone_number": "801-587-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 FOOTHILL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841121106",
            "telephone_number": "801-581-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAISLEY",
        "first_name": "THEODORE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "4803526-1205",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "UT",
            "license": "4803526-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00418797",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tpaisley3312@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.