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DESERAE JEANETTE GOBLE MD
NPI 1366415770
Family Medicine in Logan, UT

Active since February 08, 2006PECOS EnrolledAccepts Medicare AssignmentCLIA 46D2325230 · Waiver
1451 N 200 E STE 250, LOGAN, UT 84341(435) 363-7853(435) 213-3785 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 24, 2017, Sep 19, 2016 (2 updates tracked since 2016).

About Deserae Jeanette Goble Md NPPES

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

DESERAE JEANETTE GOBLE MD (NPI 1366415770) is an individual family medicine provider in Logan, Utah, licensed in Utah (5010200-1205) and active in the NPI registry since February 2006. She is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through June 9, 2027, and is affiliated with Logan Regional Hospital.

NPPES Registry Identity

NPI1366415770
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDESERAE JEANETTE GOBLECredential: MD
Location Address1451 N 200 E STE 250Logan, UT 84341-7570
Mailing Address1950 S Highway 89Perry, UT 84302-4119 · (435) 363-7853 · Fax (435) 213-3785
Phone(435) 363-7853
Fax(435) 213-3785
Sole ProprietorNo
Medical School CMSGeorge Washington University School Of MedicineGraduated 1997
Enumeration DateFebruary 8, 2006
Last NPPES UpdateAugust 31, 20212 updates tracked since enumeration
NPPES CertifiedAugust 31, 2021
✔ NPI 1366415770 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in UT · 5010200-1205✔ Licensed in CA · A93148
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1451 N 200 E STE 250, Logan, UT 84341
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Other Names 1

Former Name (1)Deserae J Goble Sadeghi

Other Identifiers 1

Medicaid1366415770UT

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, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Deserae Jeanette Goble Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002830239
PECOS Enrollment IDI20071011000091
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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2325230

Deserae J Goble MD PC · Logan, UT
Active · expires Jun 9, 2027
CLIA Number46D2325230
Laboratory TypePhysician Office
Certificate Effective DateJune 10, 2025
Certificate Expiration DateJune 9, 2027
Laboratory DirectorDr. Deserae J. Goble
Laboratory Phone(435) 363-7853
Laboratory LocationDeserae J Goble MD PC1451 N 200 E Ste #250, Logan, UT 84341
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
98 services34 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
28 services28 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
17 services13 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Logan Regional Hospital

Acute Care Hospitals · Logan, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460015
Location1400 North 500 EastLogan, UT 84341 · Cache County
Emergency services Birthing friendly

Brigham City Community Hospital

Acute Care Hospitals · Brigham City, UT
OwnershipProprietary
CMS Certification Number460017
Location950 South Medical DriveBrigham City, UT 84302 · Box Elder County
Emergency services Birthing friendly

Cache Valley Hospital

Acute Care Hospitals · North Logan, UT
OwnershipProprietary
CMS Certification Number460054
Location2380 North 400 EastNorth Logan, UT 84341 · Cache County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84341 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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier22 claims22 services$194.57 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

DESERAE J GOBLE MD PC
Family Medicine
1451 N 200 E STE 250
LOGAN, UT 84341
Cache County (435) 363-7853

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 Deserae Goble's NPI number?

The NPI number for Deserae Goble is 1366415770. It was assigned to this individual provider in the NPPES registry on February 8, 2006. The provider is also known as Deserae J Goble Sadeghi.

Where is Deserae Goble located?

Deserae Goble practices at 1451 N 200 E Ste 250, Logan, UT 84341. The listed phone number is (435) 363-7853.

What is Deserae Goble's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Deserae Goble enrolled in Medicare?

Yes. Deserae Goble is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Deserae Goble hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2325230) is associated with this NPI, valid through June 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Deserae Goble accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Deserae Goble 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.

Is Deserae Goble affiliated with any hospitals?

According to CMS data, Deserae Goble is affiliated with Logan Regional Hospital, Brigham City Community Hospital and Cache Valley Hospital.

When was this NPI record last updated?

The NPPES record for Deserae Goble was last updated on August 31, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.