DR. FREDERIC M III CIVISH – Family Medicine Physician, NPI 1124137278
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,136 FAMILY PRACTICE in UT
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Provider Addresses for DR. FREDERIC M III CIVISH
3354, West 7800 South, West Jordan, Salt Lake County, Utah, 84088, United States
WEST JORDAN, UT 840884506
Phone: (801) 282-2677
Fax: (801) 282-4654
Type: Mailing
3534, 6000 West, West Valley City, Salt Lake County, Utah, 84128, United States
WEST VALLEY, UT 841282610
Phone: (801) 969-6264
Fax: (801) 969-6333
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 81 Open Payments records for all available years, with a total value of $1,521.
Total Amount is formed as General ($1,521) + Research ($0) + Ownership ($0) = $1,521.
Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ABBVIE INC. ($435).
Total Amount
$1,521
General + Research + Ownership
Payments
81
Total payment records
General Amount
$1,521
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $435 |
| PFIZER INC. | $134 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $118 |
| Amgen Inc. | $104 |
| AstraZeneca Pharmaceuticals LP | $68 |
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: 2004-04-15
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 |
|---|---|---|---|---|
| I20040415000335 | I | Family Practice | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 122 | 91 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 80 | 64 | $0 |
| 81003 | Automated urinalysis test | 53 | 45 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 52 | 19 | $0 |
| 82570 | Creatinine level to test for kidney function or muscle injury | 47 | 40 | $0 |
Insurance plans in this area (ZIP 84088)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Physician Assistant | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT | |
| Nurse Practitioner | UT |
Reviews
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