Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mark Douglas Ebert, MD

Individual provider Pediatric Radiology Physician · NPI 1609901610

Dr. Mark Douglas Ebert, MD is a Diagnostic Radiology in Salt Lake City, Utah. Graduated from Johns Hopkins University School of Medicine in 2006, 20 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group and accepts Medicare assignment. Licensed in Idaho, Montana and Utah.

Years since qualifying
20
Trained at
Johns Hopkins University School of Medicine
Licensed in
ID, MT, UT
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

100 N Mario Capecchi Dr Dept OF Medical Imaging
Salt Lake City, UT 84113-1103
Phone: (801) 875-1586
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Radiology Physician (primary) Taxonomy 2085P0229X · Licence 8209945-1205 (UT)
Pediatric Radiology Physician Taxonomy 2085P0229X · Licence M-11694 (ID)
Pediatric Radiology Physician Taxonomy 2085P0229X · Licence MED-PHYS-LIC-52597 (MT)

Record details

NPI number1609901610
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 22, 2007
Last updated in NPPESAugust 23, 2023
Certification dateAugust 23, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolJOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2006 (20 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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