KELLY DAHLSTROM D.O.
NPI 1134533417
Radiology - Neuroradiology in Salt Lake City, UT

Active since June 16, 2014PECOS EnrolledAccepts Medicare Assignment
91.89/100
CMS Quality Rating
30 N 1900 E RM 1A071, SALT LAKE CITY, UT 84132(801) 581-7553 Get Directions Write a Review

NPPES record last updated: May 5, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 5, 2020, Jun 10, 2019 (2 updates tracked since 2019).

About Kelly Dahlstrom D.o. NPPES

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

KELLY DAHLSTROM D.O. (NPI 1134533417) is an individual neuroradiology provider in Salt Lake City, Utah, licensed in Utah (11262272-1204) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS, is affiliated with University Of Kansas Hospital, and maintains a secondary practice location in Fort Worth.

NPPES Registry Identity

NPI1134533417
Entity TypeIndividualFemale
Primary Taxonomy2085N0700X
Provider Legal NameKELLY DAHLSTROMCredential: D.O.
Location Address30 N 1900 E RM 1A071Salt Lake City, UT 84132-2140
Mailing Address30 N 1900 E Rm 1a071Salt Lake City, UT 84132-2140 · (801) 581-7553
Sole ProprietorYes
Medical School CMSKansas City University Of Med & Biosciences, College Of Osteo MedGraduated 2014
Enumeration DateJune 16, 2014
Last NPPES UpdateMay 5, 20202 updates tracked since enumeration
NPPES CertifiedMay 5, 2020
NPI 1134533417 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyRadiology · NeuroradiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085N0700X
License Licensed in UT · 11262272-1204
Definition

A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children.

Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X · License 11262272-1204 (UT)
30 N 1900 E RM 1A071, Salt Lake City, UT 84132

Secondary Practice Location 1

Location 11500 S Main StFort Worth, TX 76104-4917 · Phone (817) 702-1255

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

Kelly Dahlstrom D.o. 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 ID5496052474
PECOS Enrollment IDI20210723001610
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.

Areas of Expertise CMS Part B claims 27

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ct scan head or brain without contrast 70450
A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.
379 services348 patients
Mri scan of brain before and after contrast 70553
An MRI scan of the brain, both before and after contrast, helps visualize different brain structures. Initially, images are taken without a contrast agent. Then, a safe dye is injected which helps highlight certain areas, providing clearer, more detailed images.
242 services234 patients
Mri scan of brain without contrast 70551
An MRI scan of the brain without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to create detailed images of your brain. It helps in detecting abnormalities like tumors, stroke, inflammation, or infection.
127 services122 patients
Ct scan of blood vessels of head with contrast 70496
A CT scan of the head's blood vessels with contrast is a diagnostic procedure. A special dye (contrast) is injected into your body to make the blood vessels visible on the scan. This helps identify issues like blockages or abnormalities in your head's blood vessels.
93 services91 patients
Ct scan of upper spine without contrast 72125
A CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.
88 services87 patients
Ct scan of blood vessels of neck with contrast 70498
A CT scan of the neck's blood vessels with contrast is a diagnostic procedure. It uses X-rays and a special dye to create detailed images of your neck's blood vessels. This helps doctors detect issues such as blockages or abnormalities.
83 services83 patients

Hospital Affiliations CMS Care Compare 4

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

University Of Kansas Hospital

Acute Care Hospitals · Kansas City, KS
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number170040
Location4000 Cambridge StreetKansas City, KS 66160 · Wyandotte County
Emergency services Birthing friendly

Adventhealth Shawnee Mission

Acute Care Hospitals · Shawnee Mission, KS
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number170104
Location9100 W 74th StreetShawnee Mission, KS 66204 · Johnson County
Emergency services Birthing friendly

Lmh

Acute Care Hospitals · Lawrence, KS
4/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number170137
Location325 Maine StreetLawrence, KS 66044 · Douglas County
Emergency services Birthing friendly

University Of Ks Hlth System Great Bend Campus

Acute Care Hospitals · Great Bend, KS
3/5 CMS rating
OwnershipProprietary
CMS Certification Number170191
Location514 Cleveland StreetGreat Bend, KS 67530 · Barton County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.89/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality75.17
Promoting Interoperability100
Improvement Activities40

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.

Radiology (Diagnostic Radiology)
30 N 1900 E RM 1A071
SALT LAKE CITY, UT 84132
Radiology (Vascular & Interventional Radiology)
30 N 1900 E RM 1A071
SALT LAKE CITY, UT 84132
Radiology (Diagnostic Radiology)
30 N 1900 E RM 1A071
SALT LAKE CITY, UT 84132
Radiology (Diagnostic Radiology)
30 N 1900 E RM 1A071
SALT LAKE CITY, UT 84132
Radiology (Diagnostic Radiology)
30 N 1900 E RM 1A071
SALT LAKE CITY, UT 84132
Radiology (Diagnostic Radiology)
30 N 1900 E RM 1A071
SALT LAKE CITY, UT 84132
Radiology (Diagnostic Radiology)
30 N 1900 E RM 1A071
SALT LAKE CITY, UT 84132
Radiology (Neuroradiology)
30 N 1900 E RM 1A071
SALT LAKE CITY, UT 84132

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134533417, enumerated as an "individual" on June 16, 2014.

The provider is located at 30 N 1900 E RM 1A071 SALT LAKE CITY, UT 84132 and the phone number is (801) 581-7553.

Radiology with taxonomy code 2085N0700X and a focus in Neuroradiology.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Kansas City, Blue. Please consult your insurance carrier or call the provider to verify.

Kelly Dahlstrom is affiliated with: UNIVERSITY OF KANSAS HOSPITAL, ADVENTHEALTH SHAWNEE MISSION, LMH and UNIVERSITY OF KS HLTH SYSTEM GREAT BEND CAMPUS.