Organization Active NPI

Physicians Medical Group

  • Vascular & Interventional Radiology Physician
  • Salt Lake City, UT
National Provider Identifier
1972078723
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
PHYSICIANS MEDICAL GROUP
Practice address
4624 S Holladay Blvd Ste 202
Salt Lake City, UT 84117-7168
Phone
(385) 800-5015
Fax
(801) 277-6678
NPI assigned
Oct 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Authorized official

Name
Jenny Simbari
Title
Biller
Phone
(385) 800-5015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

4624 S Holladay Blvd Ste 202
Salt Lake City, UT 84117-7168

Mailing address

4624 S Holladay Blvd Ste 202
Salt Lake City, UT 84117-7168
Phone (801) 810-2999

Other identifiers 6

IdentifierTypeStateIssuer
1740543834OtherUTINDIVIDUAL NPI
1619935053OtherUTINDIVIDUAL NPI
1184807208OtherUTINDIVIDUAL NPI
1356897821OtherUTINDIVIDUAL NPI
1861622219OtherUTINDIVIDUAL NPI
1972078723OtherUTGROUP NPI

Other names 1

  • Evolve Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181210001640 UT Part B Supplier - Clinic/Group Practice 7214271725 Receives reassigned benefits from 5 practitioners
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766707200000",
    "number": "1972078723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 S HOLLADAY BLVD STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841177168",
            "telephone_number": "801-810-2999",
            "fax_number": "801-407-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4624 S HOLLADAY BLVD STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841177168",
            "telephone_number": "385-800-5015",
            "fax_number": "801-277-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A",
        "authorized_official_last_name": "SIMBARI",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "385-800-5015"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1740543834",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1619935053",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1184807208",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1356897821",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1861622219",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1972078723",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.