Michael B Wilson, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

7205671-1205 Issued in UT

Practice address

4000 S 700 E Ste 10
Salt Lake City, UT 84107-2580

Phone

(801) 268-4141

Fax

(801) 261-8609

NPI assigned

May 20, 2015

Sex

Male

Sole proprietor

No

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

Otolaryngology

Education

Washington University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT Professional Association ServicesGroup PAC ID 8921053349, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mark'S Hospital Hospital, Salt Lake City, UT, CCN 460047
• Intermountain Medical Center Hospital, Murray, UT, CCN 460010

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• UT PPO D-SNP
• UT PPO

Interoperability endpoints

• Direct secure messaging: mwilson@entslc.emadirect.md

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.

• ENT Professional Association Services

  • Otolaryngology Physician
  • SLC, UT
  • NPI 1801857271
  Medicare reassignment Care Compare group NPD
• Utah Surgery Center LP

  • Ambulatory Surgical Clinic/Center
  • Draper, UT
  • NPI 1598772634
  NPD (past)

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

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • Murray, UT
  • NPI 1043220650
  Care Compare affiliation
• Northern Utah Healthcare Corporation

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1164801411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 S 700 E STE 10",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072580",
            "telephone_number": "801-268-4141",
            "fax_number": "801-261-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 S 700 E STE 10",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841072580",
            "telephone_number": "801-268-4141",
            "fax_number": "801-261-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-20",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "UT",
            "license": "7205671-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen B Wilson, MD
• Kia Wilson, PA
• Lindsey Wilson
• Marnie Wilson, CSW
• Melissa Wilson
• Michael R Wilson
• Natalie Mo'Otafao Wilson
• Nathan Wilson, PHARMD
• Phillip Egbert Wilson, M.D., PH.D.
• Richard Wilson

• Otolaryngology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Otolaryngology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.