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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

DR. EDIS HAZEL TICAS GOMEZ
NPI 1083534861
Student in an Organized Health Care Education/Training Program in Salt Lake City, UT

Active since July 20, 2026
27 S MARIO CAPECCHI DR, SALT LAKE CITY, UT 84112(385) 292-8854 Get Directions Write a Review

NPPES record added: July 20, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Edis Hazel Ticas Gomez NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. EDIS HAZEL TICAS GOMEZ (NPI 1083534861) is an individual student in an organized health care education/training program in Salt Lake City, Utah and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1083534861
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. EDIS HAZEL TICAS GOMEZ
Location Address27 S MARIO CAPECCHI DRSalt Lake City, UT 84112-5888
Mailing Address27 S Mario Capecchi DrSalt Lake City, UT 84112-5888 · (385) 292-8854
Phone(385) 292-8854
Sole ProprietorNo
Enumeration DateJuly 20, 2026
NPPES CertifiedJuly 20, 2026
✔ NPI 1083534861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

27 S MARIO CAPECCHI DR, Salt Lake City, UT 84112
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Other Names 1

Professional Name (2)Dr. Hazel Ticas

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADISON FISHER
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-7498
ALEXANDRA SARAH VITALE
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SLC, UT 84112
Salt Lake County (801) 213-9500
BRYAN RADMALL
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-7489
DANIELLE MARIE KELLY
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 425-8189
KARLI V LUDWIG MD
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-6437
KADE WAGERS MK
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-7498
AZRAA SAMIN AYESHA MD
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-2121
GEORGIA VEVERKA
Student in an Organized Health Care Education/Training Program
27 S MARIO CAPECCHI DR
SALT LAKE CITY, UT 84112
Salt Lake County (801) 581-7498

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edis Ticas Gomez's NPI number?

The NPI number for Edis Ticas Gomez is 1083534861. It was assigned to this individual provider in the NPPES registry on July 20, 2026. The provider is also known as Dr. Hazel Ticas.

Where is Edis Ticas Gomez located?

Edis Ticas Gomez practices at 27 S Mario Capecchi Dr, Salt Lake City, UT 84112. The listed phone number is (385) 292-8854.

What is Edis Ticas Gomez's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Edis Ticas Gomez was last updated on July 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.