MIR-MUSTAFA MIR-KASIMOV (MD) – Internal Medicine Physician, NPI 1841401155
Internal Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
153 PULMONARY DISEASE in UT
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Provider Addresses for MIR-MUSTAFA MIR-KASIMOV (MD)
370 E SOUTH TEMPLE STE 260
SALT LAKE CITY, UT 841111290
Phone: (801) 463-7415
Fax: (801) 463-7341
Type: Mailing
Mountain West Medical Center, 2055, North Main Street, Tooele, Tooele County, Utah, 84074, United States
TOOELE, UT 840749819
Phone: (801) 463-7415
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: 2007-08-07
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 |
|---|---|---|---|---|
| I20070807000310 | I | Pulmonary Disease | 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 84111)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | UT | |
| Physician Assistant | WA | |
| Nurse Practitioner | UT | |
| Physician Assistant | UT | |
| Physician Assistant | MT | |
| Physician Assistant | MA | |
| A N E S T H E S I O L O G Y | UT | |
| Pulmonary Disease, Sleep Medicine, Internal Medicine, Critical Care (Intensivists) | UT | |
| Nurse Practitioner | UT | |
| General Surgery | UT |
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