DR. DOUGLAS GAVIN KONDO M.D.
NPI 1083703284
Psychiatry & Neurology - Child & Adolescent Psychiatry in Salt Lake City, UT

Active since October 12, 2006PECOS EnrolledAccepts Medicare Assignment
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108(801) 585-1575 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Nov 17, 2021 (2 updates tracked since 2021).

About Dr. Douglas Gavin Kondo M.d. NPPES

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

DR. DOUGLAS GAVIN KONDO M.D. (NPI 1083703284) is an individual child & adolescent psychiatry provider in Salt Lake City, Utah, licensed in Utah (6313601-1205) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of University Of Utah School Of Medicine (1999).

NPPES Registry Identity

NPI1083703284
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameDR. DOUGLAS GAVIN KONDOCredential: M.D.
Location Address501 S CHIPETA WAYSalt Lake City, UT 84108-1222
Mailing AddressPo Box 413076Salt Lake City, UT 84141-3076 · (801) 213-3900
Sole ProprietorNo
Medical School CMSUniversity Of Utah School Of MedicineGraduated 1999
Enumeration DateOctober 12, 2006
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
NPPES CertifiedNovember 17, 2021
NPI 1083703284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License Licensed in UT · 6313601-1205
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 6313601-1205 (UT)
501 S CHIPETA WAY, Salt Lake City, UT 84108

Other Identifiers 2

Other11725447UT · Caqh Number
Other6313601-1205UT · Utah Medical License

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Douglas Gavin Kondo M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739142332
PECOS Enrollment IDI20070309000269
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number460009
Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County
Emergency services Birthing friendly

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.

Psychiatry & Neurology (Psychiatry)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Student in an Organized Health Care Education/Training Program
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Clinic/Center (Adolescent and Children Mental Health)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Psychiatry & Neurology (Child & Adolescent Psychiatry)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Counselor (Mental Health)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Student in an Organized Health Care Education/Training Program
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Registered Nurse
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Counselor (Mental Health)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108

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 Douglas Kondo's NPI number?

The NPI number for Douglas Kondo is 1083703284. It was assigned to this individual provider in the NPPES registry on October 12, 2006.

Where is Douglas Kondo located?

Douglas Kondo practices at 501 S Chipeta Way, Salt Lake City, UT 84108. The listed phone number is (801) 585-1575.

What is Douglas Kondo's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Douglas Kondo enrolled in Medicare?

Yes. Douglas Kondo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Douglas Kondo accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and Select Health list Douglas Kondo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Douglas Kondo affiliated with any hospitals?

According to CMS data, Douglas Kondo is affiliated with University Of Utah Hospitals And Clinics.

When was this NPI record last updated?

The NPPES record for Douglas Kondo was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.