Individual provider Active NPI

Benjamin Zenger

  • Family Medicine Physician
  • Roosevelt, UT
National Provider Identifier
1861073728
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14022445-1205 Issued in UT
Practice address
210 W 300 N
Roosevelt, UT 84066-2336
Phone
(435) 725-7448
Fax
(435) 722-9291
NPI assigned
Apr 20, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 14022445-1205 UT Primary

Addresses

Primary practice location

210 W 300 N
Roosevelt, UT 84066-2336

Mailing address

210 W 300 N
Roosevelt, UT 84066-2336
Phone (435) 725-7448

Other practice location 1

311 E Matthews Ave
Jonesboro, AR 72401-3125
Phone (870) 972-0063

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
I20240805002489 UT Practitioner - Family Practice 7618372905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uintah Basin Medical CenterGroup PAC ID 0244131944, 62 clinicians
Northeastern Utah Medical GroupGroup PAC ID 2961496609, 52 clinicians

Practice addresses (Care Compare)

210 W 300
Roosevelt, UT 84066-2336

250 W 300
Roosevelt, UT 84066-2336
Phone (435) 722-4691

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14022445-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Five Rivers Medical Center Inc Current Accepting new patients
Northeastern Utah Medical Group CurrentSince Aug 5, 2024 Accepting new patients
Uintah Basin Medical Center CurrentSince Aug 2, 2024 Accepting new patients
Uintah Basin Medical Center CurrentSince Aug 2, 2024 Accepting new patients
Northeastern Utah Medical Group Family Medicine CurrentSince Aug 5, 2024 Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients

Locations

2801 Medical Center Dr
Pocahontas, AR 72455
Phone (870) 892-6000

50 E 200 S
Duchesne, UT 84021
Phone (435) 738-2426

210 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

250 W 300 N
#752
Roosevelt, UT 84066
Phone (435) 722-4691

250 W 300 N
Ste 75
Roosevelt, UT 84066

250 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

Interoperability endpoints

  • Direct secure messaging: bzenger@frmc.medalliesdirect.net
  • Direct secure messaging: bzenger@sbpc.medalliesdirect.net

Organizations & group practices 6

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": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1861073728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 300 N",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662336",
            "telephone_number": "435-725-7448",
            "fax_number": "435-722-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W 300 N",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662336",
            "telephone_number": "435-725-7448",
            "fax_number": "435-722-9291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 E Matthews Ave",
            "address_purpose": "LOCATION",
            "city": "Jonesboro",
            "state": "AR",
            "postal_code": "724013125",
            "country_code": "US",
            "telephone_number": "870-972-0063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZENGER",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "14022445-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, UT

Sources for this page

Verify at the official NPI Registry.