Doctor profile · Federal record

Dr. Jason Petersen, MD

Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician · Plastic Surgery Physician · Salt Lake City, UT

  • NPI 1215105804
  • 18 yrs on file
  • Male
  • Group practice
  • No sanctions

Practice & contact

NPPES Updated May 11, 2026
Primary practice
5353 S 960 E, #150
Salt Lake City, UT 841173569
(801) 261-5791
fax (801) 747-7740

Credentials & registration

NPPES · NUCC
NPI registered
February 2008 — 18 yrs on file
Profile last updated
August 7, 2012
Specialty taxonomy
2082S0099X — NUCC code
State license (1)
Utah #83185641205

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1215105804. Last verified May 11, 2026.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$199
Transactions
6
Manufacturers
5
Payer (manufacturer) Industry Txns Amount
REVANCE THERAPEUTICS, INC. 2 $95.90
Mentor Worldwide LLC 1 $34.90
ABBVIE INC. 1 $25.20
TELA Bio, Inc. 1 $21.74
MOTIVA USA, LLC 1 $21.01

By nature of payment

Food and Beverage
$199

Frequently asked questions

Auto-generated from federal data
What is Dr. Jason Petersen's medical specialty?
Dr. Jason Petersen practices Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician in Salt Lake City, UT.
Where does Dr. Jason Petersen practice?
Dr. Jason Petersen practices at 5353 S 960 E, Salt Lake City, UT 841173569. Office phone: 8012615791.
What is Dr. Jason Petersen's NPI?
Dr. Jason Petersen's National Provider Identifier (NPI) is 1215105804, issued by NPPES.