DEREK BENJAMIN CARMACK CPSS, CSW
NPI 1730653254
Social Worker - Clinical in Provo, UT

Q: What is Derek Carmack's NPI number?

The NPI number for Derek Carmack is 1730653254. It was assigned to this individual provider in the NPPES registry on January 17, 2019.

Q: What is Derek Carmack's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Derek Carmack was last updated on July 20, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since January 17, 2019PECOS EnrolledAccepts Medicare Assignment

750 N FREEDOM BLVD, PROVO, UT 84601(801) 373-4760(801) 373-0639 Get Directions Write a Review

NPPES record last updated: July 20, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 20, 2021, Jun 17, 2021, May 6, 2020 and 1 more (4 updates tracked since 2019).

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About Derek Benjamin Carmack Cpss, Csw NPPES

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

DEREK BENJAMIN CARMACK CPSS, CSW (NPI 1730653254) is an individual clinical provider in Provo, Utah, licensed in Utah (12267033-3502) and active in the NPI registry since January 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1730653254

Entity TypeIndividualMale

Primary Taxonomy1041C0700X

Provider Legal NameDEREK BENJAMIN CARMACKCredential: CPSS, CSW

Location Address750 N FREEDOM BLVDProvo, UT 84601-1677

Mailing Address750 N Freedom BlvdProvo, UT 84601-1677 · (801) 373-4760 · Fax (801) 373-0639

Phone(801) 373-4760

Fax(801) 373-0639

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateJanuary 17, 2019

Last NPPES UpdateJuly 20, 20214 updates tracked since enumeration

NPPES CertifiedJuly 20, 2021

✔ NPI 1730653254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in UT · 12267033-3502

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedPeer SpecialistTaxonomy 175T00000X · License 884 (UT)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

750 N FREEDOM BLVD, Provo, UT 84601

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derek Benjamin Carmack Cpss, Csw 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 ID4789047804

PECOS Enrollment IDI20230822004113

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 Derek Carmack reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wasatch Behavioral Health Special Service District

Same address

Community/Behavioral Health

750 N FREEDOM BLVD, SUITE 300
Provo, UT 84601

Reassigned Medicare billing, Utah enrollment
141 clinicians in this Medicare group

NPI 1356357115 (801) 373-4760

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 84601 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

$0.00 typical visit price

range $54.34 – $166.03

Typical copayment $0.00 (range $13.58 – $41.50)

Most-billed visit code NA

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

ELIZA RACHELLE GEDGE PH.D., LP

Psychologist (Clinical)