Steven Ellsworth Kelly, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

12750920-1205 Issued in UT

Practice address

62 E Thrive Dr Ste 220
Saratoga Springs, UT 84045-5560

Phone

(801) 768-8800

Fax

(801) 820-8200

NPI assigned

Aug 2, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utah Valley Dermatology PCGroup PAC ID 7113181355, 11 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Utah Valley Dermatology PC

  • Dermatology Physician
  • Lehi, UT
  • NPI 1922368927
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1154809002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 E MAIN ST",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840432241",
            "telephone_number": "801-768-8800",
            "fax_number": "801-820-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 E THRIVE DR STE 220",
            "city": "SARATOGA SPRINGS",
            "state": "UT",
            "postal_code": "840455560",
            "telephone_number": "801-768-8800",
            "fax_number": "801-820-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 E Main St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Lehi",
            "state": "UT",
            "postal_code": "840432251",
            "country_code": "US",
            "telephone_number": "801-768-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "STEVEN",
        "middle_name": "ELLSWORTH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-02",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "12750920-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karston Juber
• Mattie Juber
• Mistie Juber
• Madison Judd
• Sara Kelly
• Kelsey Furr LLC
• Kemp Chiropractic
• David Kemp, D.C.
• Jacie Kemp
• Allison Ketcher

• Dermatology Physician in Saratoga Springs, UT
• Providers in Saratoga Springs, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.