Individual provider Active NPI

Kristin M Leiferman, M.D.

  • Clinical & Laboratory Dermatological Immunology Physician
  • Salt Lake City, UT
National Provider Identifier
1619064110
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X
License
49298911205 Issued in UT
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-1100
Phone
(801) 581-2955
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 49298911205 UT
Procedural Dermatology Physician 207NS0135X 49298911205 UT
Clinical & Laboratory Dermatological Immunology Physician 207NI0002X 49298911205 UT Primary

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-1100

Mailing address

PO Box 3208
Salt Lake City, UT 84110-3208
Phone (801) 587-6340

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kleiferman49555@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051229000622 UT Practitioner - Dermatology 9436171782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Mayo Medical School, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Division University of Utah Medical CenterGroup PAC ID 9638073497, 73 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 587-6340

Merit-based Incentive Payment System (MIPS)

Final score
81.84 of 100Reported as group
Quality
87.03
Promoting interoperability
100
Improvement activities
40
Cost
52.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49298911205UTMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
Dermatology Division University of Utah Medical Center Dermatology CurrentSince Oct 1, 2001 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
U-U Pediatric Dermatology PastSince May 24, 2020 Accepting new patients

Locations

6095 S 300 E
Murray, UT 84107

417 S Wakara Way
Salt Lake City, UT 84108
Phone (801) 581-3506

250 E 200 S
Ste 1350
Salt Lake City, UT 84111
Phone 80158763362003

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1619064110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3208",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103208",
            "telephone_number": "801-587-6340",
            "fax_number": "801-587-6346"
        },
        {
            "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": "841321100",
            "telephone_number": "801-581-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIFERMAN",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "49298911205",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "UT",
            "license": "49298911205",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "UT",
            "license": "49298911205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kleiferman49555@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": "841321100",
            "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.