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UMAPRASANNA S KARNAM MD
NPI 1689623852
Internal Medicine - Gastroenterology in Riverton, UT

Active since May 08, 2006PECOS EnrolledAccepts Medicare Assignment
93.33/100
CMS Quality Rating
1543 W. 12600 S., STE 102, RIVERTON, UT 84065(801) 563-5121(801) 566-3926 Get Directions Write a Review

NPPES record last updated: December 11, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Umaprasanna S Karnam Md NPPES

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

UMAPRASANNA S KARNAM MD (NPI 1689623852) is an individual gastroenterology provider in Riverton, Utah, licensed in Utah (50222851205) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Holy Cross Hospital - Salt Lake, and is a graduate of Other (1993).

NPPES Registry Identity

NPI1689623852
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameUMAPRASANNA S KARNAMCredential: MD
Location Address1543 W. 12600 S., STE 102Riverton, UT 84065-7000
Mailing Address1543 W. 12600 S., Ste 102Riverton, UT 84065-7000 · (801) 563-5121 · Fax (801) 566-3926
Phone(801) 563-5121
Fax(801) 566-3926
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateMay 8, 2006
Last NPPES UpdateDecember 11, 2015
✔ NPI 1689623852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License✔ Licensed in UT · 50222851205
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
1543 W. 12600 S., Riverton, UT 84065
Open in Google Maps ↗

Other Identifiers 9

Other100016596UT · Palmetto Gba
Other870281028UMAUT · Emia
Other68578UT · Pehp
Other107011519101UT · Ihc Healthplans
Other29-00115UT · United Healthcare
Other744958UT · Dmba
OtherQM0000057554UT · Altius
Medicare UPINH65840UT
Medicaid870281028000UT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Umaprasanna S Karnam Md 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 ID6103860242
PECOS Enrollment IDI20050620000221
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.

Medicare Billing Reassignment

Medicare enrollment records show Umaprasanna Karnam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gut Whisperer PC
0.2 mi
Gastroenterology
1543 W. 12600 S., SUITE 102
Riverton, UT 84065
  • Reassigned Medicare billing, Utah enrollment
  • 5 clinicians in this Medicare group
NPI 1619139169 (801) 563-5121

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 11

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

Biopsy of large bowel using a flexible endoscope 45380
A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.
171 services171 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
155 services147 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
109 services97 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
90 services72 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
87 services87 patients
Diagnostic exam of large bowel using a flexible endoscope 45378
This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.
77 services77 patients

Hospital Affiliations CMS Care Compare 5

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

Holy Cross Hospital - Salt Lake

Acute Care Hospitals · Salt Lake City, UT
2/5 CMS rating
OwnershipProprietary
CMS Certification Number460003
Location1050 East South TempleSalt Lake City, UT 84102 · Salt Lake County
Emergency services

Intermountain Medical Center

Acute Care Hospitals · Murray, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460010
Location5121 South Cottonwood StreetMurray, UT 84107 · Salt Lake County
Emergency services Birthing friendly

Holy Cross Hospital-Jordan Valley

Acute Care Hospitals · West Jordan, UT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460051
Location3580 West 9000 SouthWest Jordan, UT 84088 · Salt Lake County
Emergency services Birthing friendly

Park City Hospital

Acute Care Hospitals · Park City, UT
5/5 CMS rating
OwnershipProprietary
CMS Certification Number460057
Location900 Round Valley DrivePark City, UT 84060 · Summit County
Emergency services Birthing friendly

Riverton Hospital

Acute Care Hospitals · Riverton, UT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460058
Location3741 West 12600 SouthRiverton, UT 84065 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84065 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
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

93.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.66
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%257 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152
Other-Enteral and Parenteral · category OB006N
1 supplier11 claims4,234 services$0.32 avg. paid by Medicare
Parenteral nutrition solution, not otherwise specified, 10 grams lipids B4185
Other-Enteral and Parenteral · category OB005N
1 supplier50 claims1,149 services$4.56 avg. paid by Medicare
Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix B4197
Other-Enteral and Parenteral · category OB005N
1 supplier48 claims310 services$253.93 avg. paid by Medicare
Parenteral nutrition supply kit; premix, per day B4220
Other-Enteral and Parenteral · category OB005N
1 supplier49 claims317 services$8.03 avg. paid by Medicare
Parenteral nutrition administration kit, per day B4224
Other-Enteral and Parenteral · category OB005N
1 supplier49 claims317 services$25.09 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

GUT WHISPERER PC
Internal Medicine (Gastroenterology)
1543 W. 12600 S., SUITE 102
RIVERTON, UT 84065
Salt Lake County (801) 563-5121

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 Umaprasanna Karnam's NPI number?

The NPI number for Umaprasanna Karnam is 1689623852. It was assigned to this individual provider in the NPPES registry on May 8, 2006.

Where is Umaprasanna Karnam located?

Umaprasanna Karnam practices at 1543 W. 12600 S. Ste 102, Riverton, UT 84065. The listed phone number is (801) 563-5121.

What is Umaprasanna Karnam's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Umaprasanna Karnam enrolled in Medicare?

Yes. Umaprasanna Karnam 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.

Which organization bills Medicare for Umaprasanna Karnam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Umaprasanna Karnam reassigns Medicare benefits to Gut Whisperer PC (Riverton, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Umaprasanna Karnam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Umaprasanna Karnam accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and BridgeSpan Health Company and 5 other insurers list Umaprasanna Karnam 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 Umaprasanna Karnam affiliated with any hospitals?

According to CMS data, Umaprasanna Karnam is affiliated with Holy Cross Hospital - Salt Lake, Intermountain Medical Center, Holy Cross Hospital-Jordan Valley, Park City Hospital and Riverton Hospital.

When was this NPI record last updated?

The NPPES record for Umaprasanna Karnam was last updated on December 11, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.