NPIMap

Individual provider Active NPI

Paul Stevens, M.D.

  • Child & Adolescent Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1366736886
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
361354-1205 Issued in UT
Practice address
650 S Komas Dr Ste 200
Salt Lake City, UT 84108-1241
Phone
(801) 581-5515
Fax
(801) 581-8979
NPI assigned
Jun 1, 2011
Last updated
Nov 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 361354-1205 UT Primary

Addresses

Primary practice location

650 S Komas Dr Ste 200
Salt Lake City, UT 84108-1241

Mailing address

650 S Komas Dr Ste 200
Salt Lake City, UT 84108-1241
Phone (801) 581-5515

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pstevens16133@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
I20160809001081 UT Practitioner - Neuropsychiatry 9234356627 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
University of Utah School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

240 Morris Ave
Suite 400
Salt Lake City, UT 84115-3295
Phone (801) 585-3828

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.22 of 100Reported as group
Quality
83.74
Promoting interoperability
100
Improvement activities
40
Cost
66.87

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Behavioral Health Services CurrentSince Sep 1, 2016 Accepting new patients
University of Utah Acuity Care Services CurrentSince Jan 1, 2021 Accepting new patients
University of Utah Acuity Care Services Current Accepting new patients
University of Utah Pediatric Behavioral Health Services CurrentSince Sep 1, 2016 Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Sep 1, 2016 Accepting new patients
University of Utah Pediatric Acuity Care Current Accepting new patients
University of Utah Pediatric Behavioral Health Services Current Accepting new patients
University of Utah Behavioral Health Services CurrentSince Jan 18, 2017 Accepting new patients
University of Utah Behavioral Health Services CurrentSince Jan 18, 2017 Accepting new patients
University of Utah Behavioral Health Services Current Accepting new patients
University of Utah Acuity Care Services CurrentSince Jan 1, 2021 Accepting new patients
University of Utah Pediatric Acuity Care CurrentSince Sep 1, 2016 Accepting new patients

Locations

525 E 100 S
Ste 500
Salt Lake City, UT 84102
Phone (801) 585-1212

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

127 S 500 E
Ste 600
Slc, UT 84102

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

501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951

240 Morris Ave
Ste 400
South Salt Lake, UT 84115
Phone (801) 581-5515

Organizations & group practices 12

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1366736886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S KOMAS DR STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081241",
            "telephone_number": "801-581-5515",
            "fax_number": "801-581-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 S KOMAS DR STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081241",
            "telephone_number": "801-581-5515",
            "fax_number": "801-581-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "UT",
            "license": "361354-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pstevens16133@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": "841320100",
            "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.