DR. MARTA J PETERSEN (M.D.) – Dermatology Physician, NPI 1972601508
Dermatology Physician
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Profile Insights
NPPES metrics only — not quality of care.
197 DERMATOLOGY in UT
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Provider Addresses for DR. MARTA J PETERSEN (M.D.)
Salt Lake City Post Office, 1760, 2100 South, Salt Lake City, Salt Lake County, Utah, 84199, United States
SALT LAKE CITY, UT 841103208
Phone: (801) 587-6340
Fax: (801) 587-6346
Type: Mailing
50, North Medical Drive, Salt Lake City, Salt Lake County, Utah, 84113, United States
SALT LAKE CITY, UT 841321100
Phone: (801) 581-2955
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: 2005-12-28
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 |
|---|---|---|---|---|
| I20051228000309 | I | Dermatology | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 85 | 24 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 80 | 59 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 34 | 32 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 27 | 23 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 22 | 17 | $0 |
Insurance plans in this area (ZIP 84110)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | UT | 17003 | Destruction of 2-14 skin growths | 106 | 18 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | TN | |
| D E R M A T O L O G Y | CA | |
| P A T H O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | PA | |
| - | UT |
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