John Michael Self, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

3557751205 Issued in UT

Practice address

5292 So College Dr
202
Murray, UT 84123

Phone

(801) 266-3671

Fax

(801) 266-8194

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Plastic and Reconstructive Surgery

Education

University of Alabama School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mark's Hospital Hospital, Salt Lake City, UT, CCN 460047

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jed R Bindrup MD PC

  • Specialist
  • Draper, UT
  • NPI 1407002553
  NPD (past)
• Ryan K Anderson D P M P C

  dba Foot & Ankle Specialists of Utah

  • Foot & Ankle Surgery Podiatrist
  • Bountiful, UT
  • NPI 1639200215
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northern Utah Healthcare Corporation

  dba St. Mark's Hospital

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1164469243
  Care Compare affiliation

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912012287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5292 SO COLLEGE DR",
            "address_2": "202",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84123",
            "telephone_number": "801-266-3671",
            "fax_number": "801-266-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5292 SO COLLEGE DR",
            "address_2": "202",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84123",
            "telephone_number": "801-266-3671",
            "fax_number": "801-266-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "UT",
            "license": "3557751205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Sedillo
• Sego Lily Center for the Abused Deaf
• Gregory Sego, FNP-C, RN, BSN
• Ian Englebert Seitz
• Kimberly Seitz, PTA
• Tomoki Sempokuya, M.D.
• Alpana Senapati
• Senior Nurse Practitioner Consultants
• Michael Sentome
• Chase Sessions, D.O.

• Plastic Surgery Physician in Murray, UT
• Providers in Murray, UT by specialty
• Plastic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.