MARK C SANDERSON (MD) – Plastic and Reconstructive Surgery Physician, NPI 1073604609
Plastic and Reconstructive Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MARK C SANDERSON (MD)
Revere Health, 1055, North 500 West, North Park, Provo, Utah County, Utah, 84604, United States
CREDENTIALING DEPARTMENT
PROVO, UT 846043305
Phone: (801) 354-8225
Fax: (801) 418-0941
Type: Mailing
1184, East Seymore Drive, American Fork, Utah County, Utah, 84003, United States
AMERICAN FORK, UT 840032906
Phone: (801) 763-3885
Fax: (801) 763-3887
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-06-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040611000559 | I | Plastic And Reconstructive Surgery | UT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 73140 | X-ray of finger, minimum of 2 views | 61 | 34 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 43 | 32 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 35 | 35 | $0 |
| 26055 | Incision of tendon covering of finger | 23 | 21 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 22 | 21 | $0 |
Insurance plans in this area (ZIP 84604)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| - | UT | |
| Physical Therapist In Private Practice | UT | |
| Orthopedic Surgery | UT | |
| Nurse Practitioner | OR | |
| - | FL | |
| - | UT | |
| Nurse Practitioner | UT | |
| - | UT | |
| - | UT |
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