NPIMap

Individual provider Active NPI

Benjamin J. Verseman, MD

  • Emergency Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1003304122
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
12439739-1205 Issued in UT
Practice address
30 N 1900 E # 1C026
Salt Lake City, UT 84132-0002
Phone
(801) 581-2417
NPI assigned
Apr 24, 2018
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 12439739-1205 UT Primary

Addresses

Primary practice location

30 N 1900 E # 1C026
Salt Lake City, UT 84132-0002

Mailing address

30 N 1900 E # 1C026
Salt Lake City, UT 84132-0002
Phone (801) 581-2417

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bverseman440101@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230609002438 UT Practitioner - Emergency Medicine 3678979697 Reassigns benefits to 3 organizations
I20230613002966 WY Practitioner - Emergency Medicine 3678979697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Davis School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, shared by 7 NPIs, 1,758 clinicians

Practice addresses (Care Compare)

1200 College Dr
Rock Springs, WY 82901-5868
Phone (801) 581-3495

3580 W 9000
West Jordan, UT 84088-8812
Phone (801) 561-8888

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince Jan 13, 2024 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
University of Utah Adult Services CurrentSince May 15, 2023 Accepting new patients
University of Utah Adult Services CurrentSince May 15, 2023 Accepting new patients
University of Utah Pediatric Services CurrentSince Jan 13, 2024 Accepting new patients
University of Utah Adult Services CurrentSince May 15, 2023 Accepting new patients

Locations

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

630 Medical Dr
North Salt Lake, UT 84010
Phone (801) 292-6231

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

333 N 300 W
Salt Lake City, UT 84103
Phone (801) 463-7415

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

2675 W Taylorsville Blvd
Taylorsville, UT 84129
Phone (801) 982-0050

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

3460 S Pioneer Pkwy
West Valley City, UT 84120
Phone (801) 562-4210

1200 College Dr
Rock Springs, WY 82901
Phone (307) 352-8352

Interoperability endpoints

  • Direct secure messaging: bverseman440101@direct.med.utah.edu

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1003304122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E # 1C026",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E # 1C026",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERSEMAN",
        "first_name": "BENJAMIN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "12439739-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bverseman440101@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.