NPIMap

Individual provider Active NPI

Peter C. Fisher, M.D.

  • Urology Physician
  • SLC, UT
National Provider Identifier
1902847940
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
60296291205 Issued in UT
Practice address
4252 Highland Dr
#200
SLC, UT 84124-2670
Phone
(801) 993-1800
Fax
(801) 993-1699
NPI assigned
Jun 9, 2006
Last updated
Mar 16, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 60296291205 UT Primary

Addresses

Primary practice location

4252 Highland Dr
#200
SLC, UT 84124-2670

Mailing address

4252 Highland Dr
#200
SLC, UT 84124-2670
Phone (801) 993-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, HI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060531000027 UT Practitioner - Urology 2668483975 Reassigns benefits to 2 organizations
I20250313000673 HI Practitioner - Urology 2668483975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Utah School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians
Kauai Medical ClinicGroup PAC ID 5092628479, 147 clinicians

Practice addresses (Care Compare)

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

3-3420 Kuhio Hwy
Suite B
Lihue, HI 96766-1098
Phone (808) 245-1500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection23
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60296291205UTMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Clinic PC CurrentSince Dec 26, 2023 Accepting new patients
Granger Medical Specialists LLC CurrentSince Nov 1, 2020 Accepting new patients
Kauai Medical Clinic CurrentSince Mar 3, 2025 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Nov 1, 2020 Accepting new patients
Kauai Medical Clinic CurrentSince Mar 3, 2025 Accepting new patients
Granger Medical Clinic PC Past Accepting new patients

Locations

3-3420 Kuhio Hwy
Ste B
Lihue, HI 96766
Phone (808) 245-1500

995 W Levoy Dr
Taylorsville, UT 84123

7181 S Campus View Dr
Ste 200
West Jordan, UT 84084
Phone (801) 965-3505

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

Interoperability endpoints

  • Direct secure messaging: peter.fisher@gmcwv.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1902847940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4252 HIGHLAND DR",
            "address_2": "#200",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841242670",
            "telephone_number": "801-993-1800",
            "fax_number": "801-993-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4252 HIGHLAND DR",
            "address_2": "#200",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841242670",
            "telephone_number": "801-993-1800",
            "fax_number": "801-993-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "PETER",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "60296291205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

Verify at the official NPI Registry.