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AMIRA DERVISEVIC
NPI 1881360295
Registered Nurse - Psychiatric/Mental Health in Salt Lake City, UT

Active since August 17, 2021PECOS EnrolledAccepts Medicare Assignment
99.47/100
CMS Quality Rating
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108(801) 587-3270 Get Directions Write a Review

NPPES record last updated: December 20, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 20, 2021, Aug 17, 2021 (2 updates tracked since 2021).

About Amira Dervisevic NPPES

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

AMIRA DERVISEVIC (NPI 1881360295) is an individual psychiatric/mental health provider in Salt Lake City, Utah, licensed in Utah (7800211-3102) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS, is affiliated with University Of Utah Hospitals And Clinics, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1881360295
Entity TypeIndividualFemale
Primary Taxonomy163WP0808X
Provider Legal NameAMIRA DERVISEVIC
Location Address501 S CHIPETA WAYSalt Lake City, UT 84108-1222
Mailing Address6239 W Dinsmore WayWest Jordan, UT 84081-4129 · (801) 815-5125
Phone(801) 587-3270
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateAugust 17, 2021
Last NPPES UpdateDecember 20, 20212 updates tracked since enumeration
NPPES CertifiedDecember 20, 2021
✔ NPI 1881360295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Psychiatric/Mental HealthNursing Service Providers
Taxonomy Code163WP0808X
License✔ Licensed in UT · 7800211-3102
501 S CHIPETA WAY, Salt Lake City, UT 84108
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, 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

Amira Dervisevic 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 ID8628475688
PECOS Enrollment IDI20210920000451
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 Reassignments

2

Medicare enrollment records show Amira Dervisevic reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Of Utah Behavioral Health Services
Same address
Psychiatry
501 S CHIPETA WAY
Salt Lake City, UT 84108
  • Reassigned Medicare billing, Utah enrollment
  • 295 clinicians in this Medicare group
NPI 1093265654 (801) 585-1575
University Of Utah Pediatric Behavioral Health Services
Same address
Child & Adolescent Psychiatry
501 S CHIPETA WAY
Salt Lake City, UT 84108
  • Reassigned Medicare billing, Utah enrollment
  • 111 clinicians in this Medicare group
NPI 1205378320 (801) 587-6336

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

Areas of Expertise CMS Part B claims

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.

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
35 services13 patients

Hospital Affiliations CMS Care Compare

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

University Of Utah Hospitals And Clinics

Acute Care Hospitals · Salt Lake City, UT
5/5 CMS rating
OwnershipGovernment - State
CMS Certification Number460009
Location50 North Medical DriveSalt Lake City, UT 84132 · Salt Lake County
Emergency services Birthing friendly

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.

DR. ERIC THAYNE MONSON MD, PHD
Psychiatry & Neurology (Psychiatry)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 581-4096
KATRIEL TAN
Student in an Organized Health Care Education/Training Program
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (516) 497-0340
UNIVERSITY OF UTAH PEDIATRIC BEHAVIORAL HEALTH SERVICES
Clinic/Center (Adolescent and Children Mental Health)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-6336
DR. AMY GALLOP WEAGLEY MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 581-2121
ATIYA S NASH
Counselor (Mental Health)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-3000
VALERIE ELIZABETH SHAY MD
Psychiatry & Neurology (Psychiatry)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 581-7951
MAUREEN SIMES
Registered Nurse
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 583-2500
JENNIFER HARMON
Counselor (Mental Health)
501 S CHIPETA WAY
SALT LAKE CITY, UT 84108
Salt Lake County (801) 587-2460

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 Amira Dervisevic's NPI number?

The NPI number for Amira Dervisevic is 1881360295. It was assigned to this individual provider in the NPPES registry on August 17, 2021.

Where is Amira Dervisevic located?

Amira Dervisevic practices at 501 S Chipeta Way, Salt Lake City, UT 84108. The listed phone number is (801) 587-3270.

What is Amira Dervisevic's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Psychiatric/Mental Health, with taxonomy code 163WP0808X.

Is Amira Dervisevic enrolled in Medicare?

Yes. Amira Dervisevic 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.

Which organizations bill Medicare for Amira Dervisevic's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Amira Dervisevic reassigns Medicare benefits to 2 organizations: University Of Utah Behavioral Health Services (Salt Lake City, UT) and University Of Utah Pediatric Behavioral Health Services (Salt Lake City, UT). Each 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 Amira Dervisevic's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Amira Dervisevic accept?

Health plans from Molina Healthcare and University of Utah Health Plans list Amira Dervisevic 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 Amira Dervisevic affiliated with any hospitals?

According to CMS data, Amira Dervisevic is affiliated with University Of Utah Hospitals And Clinics.

When was this NPI record last updated?

The NPPES record for Amira Dervisevic was last updated on December 20, 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.