DR. GEORGE WILLIAM JR. MIDDLETON (M.D.) – Urology Physician, NPI 1376581140

DR. GEORGE WILLIAM JR. MIDDLETON (M.D.) is a healthcare provider. based in West valley city, Utah. specializing in UROLOGY. They hold the professional credentials M.D.. They hold a License No. 9701495 (NC). The NPI Number for DR. GEORGE WILLIAM JR. MIDDLETON (M.D.) is 1376581140

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. GEORGE WILLIAM JR. MIDDLETON (M.D.)
NPI
1376581140
Phone
(801) 965-3600
Address
3725 W 4100 S
Enumeration Date
3 June 2006
Last Update Date
29 November 2021

Doctor Profile

Medical School Name
SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6195285000
Graduation Year
1995 (31 years ago)
PAC ID
8123277860
Group Practice PAC ID
6002729175
Professional Enrollment ID
I20190524001531
Address ID
CA921548404SA4650XAVEX300
Telehealth
Yes

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

97 UROLOGY in UT

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Provider Addresses for DR. GEORGE WILLIAM JR. MIDDLETON (M.D.)

  • Randall's Market, 3235 W, Cody Brotherson Parkway, West Valley City, Salt Lake County, Utah, 84119, United States

    WEST VALLEY CITY, UT 841205411

    Phone: (801) 965-3600

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $50.

Total Amount is formed as General ($50) + Research ($0) + Ownership ($0) = $50.

Last reported payment date: 2024-12-31 • Largest payer in this snapshot: Teleflex LLC ($50).

Total Amount

$50

General + Research + Ownership

Payments

2

Total payment records

General Amount

$50

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-31

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Teleflex LLC$50
View all Open Payments →|Open Payments Risk Radar →

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: 2019-05-24

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190524001531IUrologyCATBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84120)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002729175View full group profile
NameSpecialtyState
U R O L O G YOH
Nurse PractitionerCA
Internal MedicineCA
Internal MedicineCA
Internal Medicine, GastroenterologyCA
Physician AssistantCA
Emergency MedicineNC
O P H T H A L M O L O G YCA
Anesthesiology, Pain ManagementNH
Family Practice, Sports MedicineCA

Reviews

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Frequently asked questions

How do I look up DR. GEORGE WILLIAM JR. MIDDLETON (M.D.) by NPI?
Use NPI 1376581140 when you need to reference DR. GEORGE WILLIAM JR. MIDDLETON (M.D.) in forms, claims, or directories.
Is DR. GEORGE WILLIAM JR. MIDDLETON (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is DR. GEORGE WILLIAM JR. MIDDLETON (M.D.)?
The page reflects Urology Physician for DR. GEORGE WILLIAM JR. MIDDLETON (M.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. GEORGE WILLIAM JR. MIDDLETON (M.D.)?
The page summarizes West Valley City, Utah for DR. GEORGE WILLIAM JR. MIDDLETON (M.D.); expand the address list for detail.
How can I contact DR. GEORGE WILLIAM JR. MIDDLETON (M.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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