DR. PETER LEE TANNER (M.D.) – Emergency Medicine Physician, NPI 1396957254

DR. PETER LEE TANNER (M.D.) is a healthcare provider. based in Roosevelt, Utah. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. 4301088735 (MI). The NPI Number for DR. PETER LEE TANNER (M.D.) is 1396957254

Main info

Male
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
DR. PETER LEE TANNER (M.D.)
NPI
1396957254
Phone
(435) 722-4691
Address
250 W 300 N
Enumeration Date
4 May 2007
Last Update Date
29 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4357224691
Graduation Year
2006 (20 years ago)
PAC ID
1153472212
Group Practice PAC ID
0244131944
Professional Enrollment ID
I20090630000649
Address ID
UT840662336RO250XX300X301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness75
Years active:19State licenses:2Digital endpointsOther names

487 EMERGENCY MEDICINE in UT

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Provider Addresses for DR. PETER LEE TANNER (M.D.)

  • Uintah Basin Medical Center, 250, West 300 North, Roosevelt, Duchesne County, Utah, 84066, United States

    ROOSEVELT, UT 840662336

    Phone: (435) 722-4691

    Fax: (435) 722-9291

    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)

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: 2009-06-30

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
I20090630000649IEmergency MedicineUTTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making116104$0
99285Emergency department visit with high level of medical decision making8074$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only7667$0
99283Emergency department visit with low level of medical decision making6756$0
99291Critical care, first 30-74 minutes5247$0
View full utilization report →

Insurance plans in this area (ZIP 84066)

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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: 0244131944View full group profile
NameSpecialtyState
General SurgeryAK
Pediatric MedicineUT
Physician AssistantUT
Family PracticeUT
Nurse PractitionerUT
P A T H O L O G YIL
Family PracticeUT
Nurse PractitionerUT
O B S T E T R I C S/ G Y N E C O L O G YUT
Physician AssistantUT

Reviews

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Frequently asked questions

What unique ID ties claims to DR. PETER LEE TANNER (M.D.)?
NPI 1396957254 is assigned to DR. PETER LEE TANNER (M.D.) under the national enumeration system.
Does this profile mean DR. PETER LEE TANNER (M.D.) is currently active?
Yes — DR. PETER LEE TANNER (M.D.) appears active in the national provider directory.
What kind of provider is DR. PETER LEE TANNER (M.D.)?
The page reflects Emergency Medicine Physician for DR. PETER LEE TANNER (M.D.). Clinical services aligned with this taxonomy classification.
Where is DR. PETER LEE TANNER (M.D.)'s primary listing?
We display Roosevelt, Utah because that is what the record indicates for DR. PETER LEE TANNER (M.D.).
Is DR. PETER LEE TANNER (M.D.) a real provider?
This page reflects official NPPES data for NPI 1396957254. Always confirm identity and privileges with the practice and licensing boards.

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