Genesis Vascular of Salt Lake
NPI 1104361591ActiveOrganization· Internal Medicine, Interventional Cardiology· Salt Lake City, UT
Internal Medicine, Interventional Cardiology in Salt Lake City, Utah, registered in NPPES in December 2016, part of Genesis Vascular of Salt Lake. The authorized official on file is Dennis Munford, Manager.
Overview
| NPI | 1104361591 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Genesis Vascular of Salt Lake |
| NPI issued | Dec 21, 2016 |
| Last updated in NPPES | Oct 7, 2020 |
| Certified by provider | Oct 7, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Interventional Cardiology Primary | 207RI0011X | — | — |
| Radiology, Vascular & Interventional Radiology | 2085R0204X | — | — |
| Surgery, Vascular Surgery | 2086S0129X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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