NPIMap

Individual provider Active NPI

Justin M Haller, MD

  • Orthopaedic Trauma Physician
  • Salt Lake City, UT
National Provider Identifier
1790009264
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
8153449-8905 Issued in UT
Practice address
590 Wakara Way
Salt Lake City, UT 84108
Phone
(801) 587-5457
Fax
(801) 587-7111
NPI assigned
Mar 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 8153449-1205 UT
Orthopaedic Trauma Physician 207XX0801X 8153449-8905 UT Primary

Addresses

Primary practice location

590 Wakara Way
Salt Lake City, UT 84108

Mailing address

50 North Medical Drive
Salt Lake City, UT 84132
Phone (801) 587-5457

Other identifiers 1

IdentifierTypeStateIssuer
1790009264MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhaller16685@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
I20160829001635 UT Practitioner - Orthopedic Surgery 6800028671 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Virginia School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone (801) 587-7109

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8153449-8905UTMDOrthopaedic Trauma Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Pediatric Services CurrentSince Oct 1, 2016 Accepting new patients
University of Utah Adult Services CurrentSince Aug 1, 2016 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Adult Services CurrentSince Aug 1, 2016 Accepting new patients
University of Utah Pediatric Services CurrentSince Oct 1, 2016 Accepting new patients
University of Utah Adult Services Current Accepting new patients
Pediatric Orthopedic Associates Past Accepting new patients

Locations

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

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

590 S Wakara Way
Slc, UT 84108
Phone (801) 587-7005

100 N Mario Capecchi Dr
#4550
Slc, UT 84113
Phone (801) 662-5600

Interoperability endpoints

  • Direct secure messaging: jhaller16685@direct.med.utah.edu

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1790009264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 NORTH MEDICAL DRIVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84132",
            "telephone_number": "801-587-5457",
            "fax_number": "801-587-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84108",
            "telephone_number": "801-587-5457",
            "fax_number": "801-587-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLER",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-26",
        "last_updated": "2025-05-28",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "UT",
            "license": "8153449-1205",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "UT",
            "license": "8153449-8905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790009264",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhaller16685@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.