Individual provider Active NPI

Ronald Raymond Trudel, MD

  • Internal Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1962455626
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4866189-1205 Issued in UT
Practice address
3465 Magic Hills Circle
Salt Lake City, UT 84121-0000
Phone
(801) 891-9313
Fax
(801) 944-2472
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 4866189-1205 UT
Hospitalist Physician 208M00000X 4866189-1205 UT
Hospitalist Physician 208M00000X 48661891205 UT
Internal Medicine Physician 207R00000X 4866189-1205 UT Primary

Addresses

Primary practice location

3465 Magic Hills Circle
Salt Lake City, UT 84121-0000

Mailing address

3465 E Magic Hills Cir
Salt Lake City, UT 84121-7243
Phone (801) 891-9313

Other identifiers 2

IdentifierTypeStateIssuer
48661891202001OtherUTBCBS
2203454002OtherUTCIGNA

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
I20040921001187 UT Practitioner - Internal Medicine 5193793784 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tooele Clinic CorpGroup PAC ID 6800700873, 63 clinicians

Practice addresses (Care Compare)

196 E 2000
Tooele, UT 84074-9335

2321 N 400
Suite 300
Tooele, UT 84074-3440
Phone (435) 833-9180

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.71 of 100Reported as group
Quality
91.38
Promoting interoperability
100
Improvement activities
40
Cost
77.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4866189-1205UTMDGeriatric Medicine (Internal Medicine) Physician
48661891205UTMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Regional Hospitalists LLC Hospitalist CurrentSince Dec 20, 2014 Accepting new patients
Utah Regional Hospitalists LLC Hospitalist CurrentSince Dec 20, 2014 Accepting new patients
Ihc Health Services, Inc. Past Accepting new patients
Medical Marts LLC Past Accepting new patients

Locations

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

2055 N Main St
Tooele, UT 84074
Phone (435) 843-3600

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 964-3111

Interoperability endpoints

  • Direct secure messaging: rrtrudel@yourcarecommunity.org

Organizations & group practices 5

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 1

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1962455626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 E MAGIC HILLS CIR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217243",
            "telephone_number": "801-891-9313",
            "fax_number": "801-944-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3465 MAGIC HILLS CIRCLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841210000",
            "telephone_number": "801-891-9313",
            "fax_number": "801-944-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDEL",
        "first_name": "RONALD",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "UT",
            "license": "4866189-1205",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "4866189-1205",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "UT",
            "license": "48661891205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "4866189-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "48661891202001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2203454002",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.