Office listed in NPPES
30 N 1900 E Rm 4C116, Salt Lake City, UT 84132
8015817606
Confirm this address and number with the practice. Registry information may be outdated.
Physician registry profile
MD · Salt Lake City, UT
30 N 1900 E Rm 4C116, Salt Lake City, UT 84132
8015817606
Confirm this address and number with the practice. Registry information may be outdated.
Confirm current services, ages treated, insurance, location, hospital affiliations and appointment availability directly with the practice. An active NPI does not verify current licensure, certification or practice status.
A registry specialty label does not establish that a clinician currently provides the particular care you need.
Reporting year: 2024. These are billed services or units in Original Medicare Part B, not total career experience, all patients, surgical case counts or a quality rating.
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| HCPCS | Billed services / units | Beneficiaries in this row | Service description (English) | Billing setting |
|---|---|---|---|---|
| 99213 | 55 | 47 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | Non-facility |
| 99214 | 451 | 205 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | Non-facility |
| 99215 | 18 | 16 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | Non-facility |
| G0439 | 124 | 124 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | Non-facility |
| G2211 | 258 | 135 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | Non-facility |
CMS suppresses provider/service rows involving fewer than 11 beneficiaries. Services may repeat for one person, and beneficiaries cannot be added across rows. Facility/non-facility describes billing and does not establish a current hospital affiliation. These counts do not report case complexity, clinical outcomes or whether a treatment is appropriate for you.
Exact CMS source rows for this NPI · Checked 2026-11-03