NPIMap

Individual provider Active NPI

Michael John Miescier, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Salt Lake City, UT
National Provider Identifier
1124108519
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
327414-1205 Issued in UT
Practice address
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone
(801) 662-1234
NPI assigned
Oct 17, 2006
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 327414-1205 UT
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 327414-1205 UT Primary

Addresses

Primary practice location

100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Mailing address

PO Box 413021
Salt Lake City, UT 84141-3021
Phone (801) 213-3900

Other identifiers 1

IdentifierTypeStateIssuer
1124108519MedicaidUT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmiescier36503@direct.med.utah.edu Direct University of Utah

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140731002916 UT Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 9335182831 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Pediatric Medicine
Education
Virginia Commonwealth University, School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 662-1234

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services Pediatrics CurrentSince Aug 1, 2016 Accepting new patients
University of Utah Pediatric Services CurrentSince Jul 28, 2019 Accepting new patients
University of Utah Pediatric Services CurrentSince Jul 28, 2019 Accepting new patients
University of Utah Pediatric Services Pediatrics Current Accepting new patients
University of Utah Pediatric Acuity Care Pediatrics Current Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Aug 1, 2016 Accepting new patients
University of Utah Pediatric Acuity Care Pediatric Emergency Medicine Past Accepting new patients
Department of Pediatrics University of Utah Pediatrics Past Accepting new patients

Locations

7495 S State St
Midvale, UT 84047
Phone (801) 213-9400

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

2000 S 900 E
Slc, UT 84105
Phone (801) 446-7786

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

Interoperability endpoints

  • Direct secure messaging: mmiescier36503@direct.med.utah.edu

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1124108519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413021",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413021",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIESCIER",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "327414-1205",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "UT",
            "license": "327414-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124108519",
            "state": "UT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmiescier36503@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.