ELIZABETH E. HAVLICEK DO
NPI 1215515952
Pediatrics - Pediatric Critical Care Medicine in Salt Lake City, UT

Q: What is Elizabeth Havlicek's NPI number?

The NPI number for Elizabeth Havlicek is 1215515952. It was assigned to this individual provider in the NPPES registry on April 1, 2021.

Q: What is Elizabeth Havlicek's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Active since April 01, 2021PECOS Enrolled

295 S CHIPETA WAY RM 2S010, SALT LAKE CITY, UT 84108(801) 581-2121 Get Directions Write a Review

NPPES record last updated: April 1, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 1, 2024, Apr 1, 2021 (2 updates tracked since 2021).

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About Elizabeth E. Havlicek Do NPPES

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

ELIZABETH E. HAVLICEK DO (NPI 1215515952) is an individual pediatric critical care medicine provider in Salt Lake City, Utah, licensed in Utah (13891769-1204) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Tampa.

NPPES Registry Identity

NPI1215515952

Entity TypeIndividualFemale

Primary Taxonomy2080P0203X

Provider Legal NameELIZABETH E. HAVLICEKCredential: DO

Location Address295 S CHIPETA WAY RM 2S010Salt Lake City, UT 84108-1287

Mailing Address295 S Chipeta Way Rm 2s010Salt Lake City, UT 84108-1287 · (801) 581-2121

Phone(801) 581-2121

Sole ProprietorNo

Enumeration DateApril 1, 2021

Last NPPES UpdateApril 1, 20242 updates tracked since enumeration

NPPES CertifiedApril 1, 2024

✔ NPI 1215515952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

License✔ Licensed in UT · 13891769-1204

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

295 S CHIPETA WAY RM 2S010, Salt Lake City, UT 84108

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Secondary Practice Location 1

Location 117 Davis Blvd Ste 308Tampa, FL 33606-3438 · Phone (813) 974-2201

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth E. Havlicek Do 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.

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.

JOSLYNN MARIE HOBURG MD

Pediatrics (Neonatal-Perinatal Medicine)