Individual provider Active NPI

Cameron Lewis Bennett, MPAS, PA-C

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1184249138
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12456910-1206 Issued in UT
Practice address
409 W 400 S
Salt Lake City, UT 84101-1135
Phone
(801) 364-0058
NPI assigned
Jun 15, 2020
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12456910-1206 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 12456910-1206 UT

Addresses

Primary practice location

409 W 400 S
Salt Lake City, UT 84101-1135

Mailing address

409 W 400 S
Salt Lake City, UT 84101-1135
Phone (801) 364-0058

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cbennett104029@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231101003108 UT Practitioner - Physician Assistant 9830545433 Reassigns benefits to 2 organizations
I20250905001309 NV Practitioner - Physician Assistant 9830545433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalcare Health Services PCGroup PAC ID 2264961861, 46 clinicians

Practice addresses (Care Compare)

1001 N 500
Provo, UT 84604-3305
Phone (505) 320-9952

1032 E 100
St George, UT 84770-3005
Phone (844) 210-6186

1525 W 2100
Salt Lake City, UT 84119-1407
Phone (801) 213-9900

2850 Ruby Vista Dr
Elko, NV 89801-1615
Phone (775) 753-5500

375 E 5350
Ogden, UT 84405-6934
Phone (844) 210-6186

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.01 of 100Reported as group
Quality
94.06
Promoting interoperability
100
Improvement activities
40
Cost
69.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Community Physicians Group CurrentSince Sep 19, 2023 Accepting new patients
University of Utah Community Physicians Group Family Medicine Past Accepting new patients
Vitalcare Medical Services PA Physician Assistant PastSince Aug 25, 2025 Accepting new patients

Locations

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

1743 Redstone Center Dr
Ste 115
Park City, UT 84098
Phone (435) 658-9200

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

220 Millpond
Ste 100
Tooele, UT 84074
Phone (435) 843-3000

Interoperability endpoints

  • Direct secure messaging: cbennett104029@direct.med.utah.edu

Organizations & group practices 5

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 3

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": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1184249138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W 400 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011135",
            "telephone_number": "801-364-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W 400 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011135",
            "telephone_number": "801-364-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "CAMERON",
        "middle_name": "LEWIS",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12456910-1206",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "12456910-1206",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbennett104029@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.