Steven Mark Kern, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G58292 Issued in CA

Practice address

1790 Sun Peak Dr Ste A103
Park City, UT 84098

Phone

(435) 658-1013

Fax

(435) 658-3513

NPI assigned

Oct 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Southern California Keck School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Karen Stolman MD PCGroup PAC ID 5890197933, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Karen Stolman MD PC

  • Dermatology Physician
  • Park City, UT
  • NPI 1235705716

  Single Specialty

  Medicare reassignment Care Compare group NPD
• J. Robert West, M.D., Inc

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1114567997

  Single Specialty

  NPD (past)
• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104814102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 CORPORATE CIR",
            "address_2": "STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890747759",
            "telephone_number": "702-360-2763",
            "fax_number": "949-783-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 SUN PEAK DR STE A103",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84098",
            "telephone_number": "435-658-1013",
            "fax_number": "435-658-3513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Homestead Rd",
            "address_2": "#30",
            "address_purpose": "LOCATION",
            "city": "Park City",
            "state": "UT",
            "postal_code": "84098",
            "country_code": "US",
            "telephone_number": "435-658-1013",
            "fax_number": "435-658-3513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 N Main St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Heber City",
            "state": "UT",
            "postal_code": "840321671",
            "country_code": "US",
            "telephone_number": "435-658-1013",
            "fax_number": "435-658-3513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20950 N Tatum Blvd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850504256",
            "country_code": "US",
            "telephone_number": "480-502-6651",
            "fax_number": "480-513-8253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 S Buffalo Dr Ste 170",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891178329",
            "country_code": "US",
            "telephone_number": "702-255-7924",
            "fax_number": "702-242-9949",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Plaza Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934546954",
            "country_code": "US",
            "telephone_number": "805-922-3632",
            "fax_number": "805-922-3522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERN",
        "first_name": "STEVEN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "330766827",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NV",
            "license": "18908",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "UT",
            "license": "3673151205",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "22469",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G58292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE",
            "identifier": "05D0692505",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mona Kazemi, OTD, OTR/L
• Lucas Ryan Keck, PA-C
• Diana M Kelly
• Kwinten Kemp
• Emily Anne Keone, CCM
• Kim Scott MD PLC
• Simon Scott Kimche, DDS
• Emily Kirkpatrick, DVM
• R Steven Klatt
• Marilyn Jean Klein, FNPC

• Dermatology Physician in Park City, UT
• Providers in Park City, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.