DEREK BRENT JOHNSON (D.O.) – Anesthesiology Physician, NPI 1962605857
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
565 ANESTHESIOLOGY in UT
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Provider Addresses for DEREK BRENT JOHNSON (D.O.)
3136, Lower Saddleback Road, Summit County, Utah, 84098, United States
PARK CITY, UT 840984829
Phone: (801) 707-7423
Type: Mailing
Cottonwood Street, Murray, Salt Lake County, Utah, 84107, United States
INTERMOUNTAIN MEDICAL CENTER
MURRAY, UT 841572520
Phone: (801) 507-5248
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: 2022-03-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20100803000236 | I | Anesthesiology | UT | TBD |
| I20220311001748 | I | Anesthesiology | HI | 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 |
|---|---|---|---|---|
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 34 | 32 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 12 | 11 | $0 |
Insurance plans in this area (ZIP 84098)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine, General Practice | OR | |
| O B S T E T R I C S/ G Y N E C O L O G Y | HI | |
| - | HI | |
| Internal Medicine, Hospitalist | HI | |
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| Cardiovascular Disease (Cardiology) | PA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | HI | |
| Orthopedic Surgery | ID | |
| A N E S T H E S I O L O G Y | HI | |
| Internal Medicine | HI |
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