James Gerald Carlisle, MD | |
1433 N 1075 W Ste 104, Farmington, UT 84025-2746 | |
(801) 298-1300 | |
(801) 296-6199 |
Full Name | James Gerald Carlisle |
---|---|
Gender | Male |
Speciality | Interventional Radiology |
Experience | 33 Years |
Location | 1433 N 1075 W Ste 104, Farmington, Utah |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750478707 | NPI | - | NPPES |
1750478707 | Medicaid | UT | |
107031591105 | Other | UT | SELECTHEALTH |
56179571211001 | Other | UT | BCBSUT |
P00808365 | Other | UT | RR MEDICARE |
847597 | Other | UT | DMBA |
P00808370 | Other | UT | RR MEDICARE |
56179571210001 | Other | UT | BCBSUT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 5617957-1205 (Utah) | Secondary |
2085R0204X | Radiology - Vascular & Interventional Radiology | 5617957-1205 (Utah) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Mark's Hospital | Salt lake city, UT | Hospital |
Lone Peak Hospital | Draper, UT | Hospital |
Ogden Regional Medical Center | Ogden, UT | Hospital |
Lakeview Hospital | Bountiful, UT | Hospital |
Mountain West Medical Center | Tooele, UT | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Green River Radiology Pc | 5294123063 | 26 |
Tooele Valley Imaging Llc | 2466624630 | 20 |
Utah Imaging Associates Inc | 1355394537 | 43 |
Wasatch Vascular Center Llc | 1951726967 | 6 |
Entity Name | Central Utah Clinic Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
Entity Name | Utah Imaging Associates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629076229 PECOS PAC ID: 1355394537 Enrollment ID: O20050228000845 |
Entity Name | Tooele Valley Imaging Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699004499 PECOS PAC ID: 2466624630 Enrollment ID: O20111012000146 |
Entity Name | Wasatch Vascular Center Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558905398 PECOS PAC ID: 1951726967 Enrollment ID: O20200807002691 |
Entity Name | Green River Radiology, P.c. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508533878 PECOS PAC ID: 5294123063 Enrollment ID: O20211027002062 |
Mailing Address | Practice Location Address |
---|---|
James Gerald Carlisle, MD Po Box 25488, Salt Lake City, UT 84125-0488 Ph: (800) 475-3698 | James Gerald Carlisle, MD 1433 N 1075 W Ste 104, Farmington, UT 84025-2746 Ph: (801) 298-1300 |
Dr. Cole Joseph Panushka, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Dr. Christopher J. Parr, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Dr. David Ray Dedrickson, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 1433 N 1075 W, Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Dr. Jason Anthony Kirkham, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Colin David Jones, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 | |
Dr. Trenton Mcneil Wright, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 | |
Dr. Craig Michael Carpenter, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1433 N 1075 W Ste 104, Farmington, UT 84025 Phone: 801-298-1300 Fax: 801-296-6199 |