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DR. PAUL SEAN CARBONE MD
NPI 1194796201
Pediatrics in Salt Lake City, UT

Active since January 27, 2006PECOS Enrolled
99.47/100
CMS Quality Rating
50 N MEDICAL DR, GENERAL PEDIATRICS, SALT LAKE CITY, UT 84132(801) 581-3501(801) 581-3899 Get Directions Write a Review

NPPES record last updated: November 11, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Paul Sean Carbone Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PAUL SEAN CARBONE MD (NPI 1194796201) is an individual pediatrics provider in Salt Lake City, Utah, licensed in Utah (61338711205) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194796201
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. PAUL SEAN CARBONECredential: MD
Location Address50 N MEDICAL DR, GENERAL PEDIATRICSSalt Lake City, UT 84132-0001
Mailing Address295 Chipeta Way, U Of U Som Dept Of PediatricsSalt Lake City, UT 84132-0001 · (801) 587-7400 · Fax (801) 587-7417
Phone(801) 581-3501
Fax(801) 581-3899
Sole ProprietorNo
Enumeration DateJanuary 27, 2006
Last NPPES UpdateNovember 11, 2021
NPPES CertifiedNovember 11, 2021
✔ NPI 1194796201 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in UT · 61338711205✔ Licensed in CA · A061998
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
50 N MEDICAL DR, Salt Lake City, UT 84132
Open in Google Maps ↗

Other Identifiers 2

MedicaidD6737UT
Medicaid100510844NV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Paul Sean Carbone Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Paul Carbone reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Utah Behavioral Health Services
Same address
Psychiatry
50 N MEDICAL DR
Salt Lake City, UT 84132
  • Reassigned Medicare billing, Utah enrollment
  • 295 clinicians in this Medicare group
NPI 1205290343 (801) 587-6336

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84132 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

99.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality91.57
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIVERSITY OF UTAH ADULT SERVICES
Otolaryngology
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 587-6336
ADAM PORTER MOTR/L
Occupational Therapist
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 585-2119
DR. ERICA JANE ALEXANDRA COLVIN MD
Emergency Medicine
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-2121
MEGAN MEIER MD
Internal Medicine (Rheumatology)
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-2121
STACI LEE GUNTER PA-C
Physician Assistant (Surgical)
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-6908
MATTHEW D. O'DELL MD
Internal Medicine
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-7899
WATARU HORIGUCHI
Student in an Organized Health Care Education/Training Program
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (801) 581-2121
JEANELLE WEBB
Registered Nurse
50 N MEDICAL DR
SALT LAKE CITY, UT 84132
Salt Lake County (925) 510-0868

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Carbone's NPI number?

The NPI number for Paul Carbone is 1194796201. It was assigned to this individual provider in the NPPES registry on January 27, 2006.

Where is Paul Carbone located?

Paul Carbone practices at 50 N Medical Dr General Pediatrics, Salt Lake City, UT 84132. The listed phone number is (801) 581-3501.

What is Paul Carbone's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Paul Carbone enrolled in Medicare?

Yes. Paul Carbone is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Paul Carbone's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paul Carbone reassigns Medicare benefits to University Of Utah Behavioral Health Services (Salt Lake City, UT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Paul Carbone's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Paul Carbone accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Paul Carbone as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Paul Carbone was last updated on November 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.