HORACIO GUILLERMO CARVAJAL DOMINGUEZ MD
NPI 1164152567
Surgery in Salt Lake City, UT

Q: What is Horacio Carvajal Dominguez's NPI number?

The NPI number for Horacio Carvajal Dominguez is 1164152567. It was assigned to this individual provider in the NPPES registry on June 16, 2022.

Q: What is Horacio Carvajal Dominguez's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since June 16, 2022PECOS Enrolled

30 N MARIO CAPECCHI DR RM 4S100, SALT LAKE CITY, UT 84112(801) 581-6803 Get Directions Write a Review

NPPES record last updated: February 12, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Horacio Guillermo Carvajal Dominguez Md NPPES

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

HORACIO GUILLERMO CARVAJAL DOMINGUEZ MD (NPI 1164152567) is an individual surgery provider in Salt Lake City, Utah, licensed in Utah (14271822-1205) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164152567

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameHORACIO GUILLERMO CARVAJAL DOMINGUEZCredential: MD

Location Address30 N MARIO CAPECCHI DR RM 4S100Salt Lake City, UT 84112

Mailing Address30 N Mario Capecchi Dr Rm 4s100Salt Lake City, UT 84112 · (801) 581-6803

Phone(801) 581-6803

Sole ProprietorNo

Enumeration DateJune 16, 2022

Last NPPES UpdateFebruary 12, 2026

NPPES CertifiedFebruary 12, 2026

✔ NPI 1164152567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in UT · 14271822-1205

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

30 N MARIO CAPECCHI DR RM 4S100, Salt Lake City, UT 84112

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Horacio Guillermo Carvajal Dominguez Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84112 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

ALEXANDER SCHURMAN

Surgery (Vascular Surgery)