NPIMap

Individual provider Active NPI

Langley L Kushman, PA

  • Surgical Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1831475748
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
9316490-1206 Issued in UT
Practice address
175 N Medical Dr
Salt Lake City, UT 84132-5901
Phone
(801) 587-6336
NPI assigned
Oct 25, 2011
Last updated
Dec 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X 9316490-1206 UT Primary

Addresses

Primary practice location

175 N Medical Dr
Salt Lake City, UT 84132-5901

Mailing address

127 S 500 E
Suite 600
Salt Lake City, UT 84102-1959
Phone (801) 587-6336

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lscherer136634@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
I20150515002098 UT Practitioner - Physician Assistant 1153595939 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

175 N Medical Dr
University of Utah Department of NE
Salt Lake City, UT 84132-1103
Phone (801) 585-7575

50 N Medical Dr
Salt Lake City, UT 84132-0001

590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone (801) 587-7100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
77.8
Promoting interoperability
100
Improvement activities
40
Cost
65.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9316490-1206UTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 4, 2020 Accepting new patients
University of Utah Surgical Services CurrentSince Sep 1, 2021 Accepting new patients
University of Utah Adult Services CurrentSince Sep 1, 2021 Accepting new patients
University of Utah Acuity Care Services CurrentSince Jun 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Sep 1, 2021 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 4, 2020 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients
University of Utah Surgical Services Past Accepting new patients

Locations

165 N University Ave
Farmington, UT 84025
Phone (801) 213-3200

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

175 N Medical Dr
Slc, UT 84112
Phone (801) 581-6908

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

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

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": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1831475748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S 500 E",
            "address_2": "SUITE 600",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021959",
            "telephone_number": "801-587-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841325901",
            "telephone_number": "801-587-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHMAN",
        "first_name": "LANGLEY",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "UT",
            "license": "9316490-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lscherer136634@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.