NATHAN G MOMBERGER MD PC NPI 1366624991

NPI Information

  • NPI: 1366624991
  • Provider Name: NATHAN G MOMBERGER MD PC
  • Classification: Orthopaedic Surgery - 207XS0114X
  • Specialization: Adult Reconstructive Orthopaedic Surgery
  • Entity Type: Organization
  • Address: 5848 FASHION BLVD STE 110
    SALT LAKE CITY, UT
    ZIP 84107
  • Phone: (801) 314-5026

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NPI Details

NATHAN G MOMBERGER MD PC is an adult reconstructive orthopaedic surgery orthopaedic surgery in Salt Lake City, UT. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. NATHAN G MOMBERGER MD PC NPI is 1366624991. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5848 FASHION BLVD STE 110
SALT LAKE CITY, UT
ZIP 84107-121
Phone: (801) 314-5026
Fax: (801) 314-4015

The provider's authorized official is Gene R Oakes .
The authorized official title is Business Administrator and has the following contact phone number (801) 314-5026.

The enumeration date for this NPI number is 12/5/2007 and was last updated on 11/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery3208681205UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1528299949009MEDICAIDUTAH
2H22841MEDICARE UPINUTAH
3000057216MEDICARE PINUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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