Active NPI
Keegan J. Colletier, MD
- Gastroenterology Physician
- Salt Lake City, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 11899045-1205
- Practice address
- 50 N Medical Dr
Salt Lake City, UT 84132-0001 - Phone
- (515) 371-4649
- NPI assigned
- Apr 5, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 11899045-1205 | UT | Primary |
| Internal Medicine Physician | 207R00000X | 11899045-1205 | UT | |
| Gastroenterology Physician | 207RG0100X | BP10079492 | TX |
Addresses
Primary practice location
50 N Medical Dr
Salt Lake City, UT 84132-0001
Mailing address
50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (515) 371-4649
Other practice location 1
301 University Blvd
Galveston, TX 77555-0764
Phone (409) 772-0122
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kcolletier352234@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: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250906000712 | UT | Practitioner - Gastroenterology | 8921426495 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 581-4314
Hospital & facility affiliations
- University of Utah Hospital and Clinics
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 24 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 35 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP10079492 | TX | MD | Gastroenterology Physician |
| 11899045-1205 | UT | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Bronson Lakeview Hospital | Internal Medicine | Past | Accepting new patients |
Locations
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
30 N 1900 E
Rm 4C116
Slc, UT 84132
Phone (801) 581-7899
5126 W Daybreak Pkwy
South Jordan, UT 84009
Phone (801) 213-4320
Interoperability endpoints
- kcolletier352234@direct.med.utah.edu
Organizations & group practices 4
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.
-
- Rheumatology Physician
- Salt Lake City, UT
- NPI 1104220904
-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
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": "1554422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773014400000",
"number": "1437611530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 N MEDICAL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841320001",
"telephone_number": "515-371-4649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 N MEDICAL DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841320001",
"telephone_number": "515-371-4649"
}
],
"practiceLocations": [
{
"address_1": "301 University Blvd",
"address_purpose": "LOCATION",
"city": "Galveston",
"state": "TX",
"postal_code": "775550764",
"country_code": "US",
"telephone_number": "409-772-0122",
"fax_number": "409-747-0777",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLLETIER",
"first_name": "KEEGAN",
"middle_name": "J.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-05",
"last_updated": "2026-03-09",
"certification_date": "2026-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "UT",
"license": "11899045-1205",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "11899045-1205",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TX",
"license": "BP10079492",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kcolletier352234@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; 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.