BENJAMIN SUMNER (PA) – Physician Assistant, NPI 1609271188
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for BENJAMIN SUMNER (PA)
1275 E FAIRFAX RD
SALT LAKE CITY, UT 841034324
Phone: (801) 536-3500
Type: Location
3725 W 4100 S
West Valley City, UT 841205530
Phone: (801) 965-3600
Type: Location
1420 N Tracy Blvd
Tracy, CA 953763451
Phone: (209) 832-6018
Type: Location
9844 S 1300 E Ste 100
Sandy, UT 840944600
Phone: (801) 571-9433
Type: Location
7181 S CAMPUS VIEW DR STE 200
WEST JORDAN, UT 840844312
Phone: (801) 965-3505
Type: Mailing
9844 S 1300 E STE 100
SANDY, UT 840944600
Phone: (801) 571-9433
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: 2016-08-09
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 |
|---|---|---|---|---|
| I20160809001536 | I | Physician Assistant | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84103)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | UT | |
| U R O L O G Y | UT | |
| - | UT | |
| Pain Management | UT | |
| Physician Assistant | UT | |
| - | UT | |
| Sports Medicine, Family Practice | UT | |
| - | UT | |
| Family Practice | UT | |
| Internal Medicine | UT |
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