NPIMap

Individual provider Active NPI

Srinivas Kiran Tantravahi, MD

  • Hematology (Internal Medicine) Physician
  • Salt Lake City, UT
National Provider Identifier
1972742245
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
7478477-1205 Issued in UT
Practice address
University of Utah Hospital
50 North Medical Drive
Salt Lake City, UT 84132-0001
Phone
(801) 581-2121
NPI assigned
Feb 11, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X 7478477-1205 UT Primary

Addresses

Primary practice location

University of Utah Hospital
50 North Medical Drive
Salt Lake City, UT 84132-0001

Mailing address

2000 Circle of Hope Dr Ste 2100
Huntsman Cancer Institute, the University of Utah
Salt Lake City, UT 84112-5550
Phone (801) 585-0120

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stantravahi36362@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
I20150811004269 UT Practitioner - HematologyPractitioner - Internal Medicine 9638397516 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HematologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

1950 Circle of Hope Dr
Salt Lake City, UT 84112-5500
Phone (801) 581-8793

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Jul 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Jul 1, 2015 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients

Locations

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

1950 Circle of Hope Dr
Slc, UT 84112
Phone (801) 585-0100

Organizations & group practices 4

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 6

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": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1972742245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 CIRCLE OF HOPE DR STE 2100",
            "address_2": "HUNTSMAN CANCER INSTITUTE, THE UNIVERSITY OF UTAH",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841125550",
            "telephone_number": "801-585-0120",
            "fax_number": "801-585-0124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF UTAH HOSPITAL",
            "address_2": "50 NORTH MEDICAL DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANTRAVAHI",
        "first_name": "SRINIVAS",
        "middle_name": "KIRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "UT",
            "license": "7478477-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stantravahi36362@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": "841320100",
            "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.