Active NPI 1477865194 Individual Practitioner Male Practitioner

Dr. Samuel M. Wilson , DO

Dermatology • Roosevelt, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Samuel Wilson, DO is a certified Dermatology practicing in Roosevelt, UT. With approximately 16 years of clinical experience since graduating from Edward Via Col Of Osteo Medicine-Virginia Campus in 2010, Dr. Wilson delivers high-quality medical care to the local community at 210 W 300 N.

Dr. Wilson maintains professional affiliations with Northeastern Utah Medical Group, Uintah Basin Medical Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

210 W 300 N

Roosevelt, UT 840662336

Telephone 4357224691

Fax 4357229291

Associated Practice Facility / Clinic

🏢 Northeastern Utah Medical Group Facility NPI 1740482009

Medicare Profile & Education

Medical School

Edward Via Col Of Osteo Medicine-Virginia Campus

Graduation Year

2010

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Roosevelt, UT

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

16 Yrs Matches City Avg

City Avg: 16.0 Yrs

State Avg: 19.7 Yrs

Regional Practice Density

1 Specialists

Practicing in Roosevelt, UT (184 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

57.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wilson (16 Years) 16 Yrs

Roosevelt Specialty Average (16.0 Years) 16.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,156	202	$24.53	$6.38
99213 Established patient office or other outpatient visit, typically 15 minutes	365	277	$129.97	$88.45
17000 Destruction of skin growth	349	274	$170.65	$53.16
11102 Tangential biopsy of single skin lesion	226	191	$211.13	$93.45
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	106	96	$106.84	$55.07
11103 Biopsy of related skin growth, each additional growth	78	46	$115.35	$48.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	70	70	$212.74	$108.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	67	64	$197.87	$124.97
17004 Destruction of precancer skin growth, 15 or more growths	40	29	$358.50	$162.07
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	36	36	$303.00	$161.27
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	35	32	$713.40	$289.30
99202 New patient office or other outpatient visit, typically 20 minutes	32	32	$163.44	$69.00
17110 Destruction of up to 14 skin growths	27	21	$257.93	$104.82
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	25	21	$573.80	$123.59
11104 Punch biopsy, first skin growth	18	17	$263.56	$120.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	811	149	$23.61	$6.39
99213 Established patient office or other outpatient visit, typically 15 minutes	271	195	$128.48	$87.06
17000 Destruction of skin growth	237	194	$166.06	$50.85
11102 Tangential biopsy of single skin lesion	190	163	$205.28	$95.64
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	96	75	$102.58	$54.46
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	88	79	$191.82	$123.71
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	69	69	$203.28	$107.38
11103 Biopsy of related skin growth, each additional growth	67	44	$112.57	$48.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	60	60	$292.40	$161.34
17004 Destruction of precancer skin growth, 15 or more growths	30	22	$350.00	$162.54
99202 New patient office or other outpatient visit, typically 20 minutes	27	27	$155.85	$69.77
17110 Destruction of up to 14 skin growths	22	16	$252.00	$108.82
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	17	14	$705.00	$292.86
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	15	11	$567.00	$125.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	640	135	$22.58	$6.48
17000 Destruction of skin growth	198	164	$160.55	$53.72
99213 Established patient office or other outpatient visit, typically 15 minutes	170	132	$124.31	$88.00
11102 Tangential biopsy of single skin lesion	142	134	$198.83	$95.68
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	91	76	$99.35	$54.62
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	69	69	$190.78	$108.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	64	56	$179.83	$124.23
99202 New patient office or other outpatient visit, typically 20 minutes	51	51	$141.25	$70.44
11103 Biopsy of related skin growth, each additional growth	37	30	$109.30	$49.41
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	33	33	$278.09	$159.04
17110 Destruction of up to 14 skin growths	20	15	$249.20	$106.10
17004 Destruction of precancer skin growth, 15 or more growths	14	11	$339.43	$162.57
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	14	14	$700.50	$293.44
11104 Punch biopsy, first skin growth	11	11	$255.64	$122.67
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	11	11	$322.55	$129.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,508	290	$9.65	$2.87
99213 Established patient office or other outpatient visit, typically 15 minutes	545	491	$95.81	$69.95
17000 Destruction of skin growth	454	400	$93.48	$53.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	361	289	$134.28	$102.06
11102 Tangential biopsy of single skin lesion	203	192	$129.03	$43.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	90	88	$67.03	$40.49
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	77	77	$134.10	$91.02
11103 Biopsy of related skin growth, each additional growth	59	40	$68.47	$29.63
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	41	41	$204.51	$146.40
99202 New patient office or other outpatient visit, typically 20 minutes	32	32	$124.50	$65.67
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	29	27	$366.93	$197.04
17110 Destruction of up to 14 skin growths	28	21	$153.54	$79.28
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	23	20	$281.57	$85.33
17004 Destruction of precancer skin growth, 15 or more growths	21	20	$200.52	$111.09
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	19	13	$179.05	$78.49
11104 Punch biopsy, first skin growth	18	17	$179.56	$73.50
11900 Injection into skin growth, 1-7 growths	16	12	$58.00	$29.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,969	363	$6.08	$2.18
99213 Established patient office or other outpatient visit, typically 15 minutes	740	601	$77.37	$52.30
17000 Destruction of skin growth	614	500	$80.63	$54.86
11102 Tangential biopsy of single skin lesion	329	288	$102.59	$31.28
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	313	251	$54.77	$27.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	280	219	$113.07	$81.04
99202 New patient office or other outpatient visit, typically 20 minutes	108	108	$84.71	$52.94
11103 Biopsy of related skin growth, each additional growth	100	56	$55.00	$23.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	83	83	$118.24	$77.54
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	52	50	$313.00	$192.72
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	40	39	$256.00	$84.09
11900 Injection into skin growth, 1-7 growths	38	28	$58.00	$29.30
11104 Punch biopsy, first skin growth	34	30	$128.00	$49.07
17004 Destruction of precancer skin growth, 15 or more growths	28	27	$156.00	$101.31
17110 Destruction of up to 14 skin growths	25	18	$116.00	$69.61
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	19	18	$191.16	$104.35
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	18	18	$149.00	$80.39
99441 Telephone medical discussion with physician, 5-10 minutes	11	11	$65.73	$34.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,359	401	$6.01	$2.50
99213 Established patient office or other outpatient visit, typically 15 minutes	879	672	$76.33	$51.63
17000 Destruction of skin growth	706	521	$80.55	$54.25
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	408	298	$48.05	$25.92
11102 Tangential biopsy of single skin lesion	331	275	$102.00	$28.81
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	210	166	$111.69	$79.43
11103 Biopsy of related skin growth, each additional growth	121	77	$55.00	$23.65
99202 New patient office or other outpatient visit, typically 20 minutes	72	72	$80.01	$51.68
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	68	68	$113.00	$77.06
11900 Injection into skin growth, 1-7 growths	51	36	$58.00	$29.40
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	40	36	$313.00	$177.85
17004 Destruction of precancer skin growth, 15 or more growths	39	34	$156.00	$102.33
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	36	30	$181.00	$103.62
11104 Punch biopsy, first skin growth	31	28	$128.00	$48.75
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	29	24	$149.00	$73.47
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	28	23	$256.00	$84.31
17110 Destruction of up to 14 skin growths	18	16	$116.00	$68.66
11105 Punch biopsy, each additional skin growth	12	11	$63.00	$27.94
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	11	11	$304.00	$206.36
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	11	11	$264.00	$88.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,318	395	$6.02	$2.46
99213 Established patient office or other outpatient visit, typically 15 minutes	803	607	$76.08	$51.32
17000 Destruction of skin growth	685	511	$80.25	$52.59
11100 Biopsy of single growth of skin and/or tissue	456	361	$109.00	$36.90
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	411	311	$45.71	$25.43
11101 Biopsy of each additional growth of skin and/or tissue	213	117	$50.00	$25.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	150	123	$111.96	$78.62
99202 New patient office or other outpatient visit, typically 20 minutes	144	144	$80.02	$49.96
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	125	125	$113.00	$76.75
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	70	60	$311.00	$190.06
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	50	40	$181.00	$94.51
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	49	42	$256.00	$84.96
17004 Destruction of precancer skin growth, 15 or more growths	42	32	$153.00	$101.14
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	34	30	$149.00	$74.73
17110 Destruction of up to 14 skin growths	30	27	$116.00	$71.21
11900 Injection into skin growth, 1-7 growths	22	15	$58.00	$28.33
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	17	17	$192.00	$118.28
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	16	$264.00	$92.56
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	15	14	$299.00	$203.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,994	356	$6.14	$2.40
99213 Established patient office or other outpatient visit, typically 15 minutes	780	569	$73.87	$50.38
17000 Destruction of skin growth	602	440	$80.82	$51.79
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	422	324	$34.35	$25.23
11100 Biopsy of single growth of skin and/or tissue	390	314	$105.81	$35.76
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	145	145	$114.56	$75.17
11101 Biopsy of each additional growth of skin and/or tissue	142	94	$50.00	$24.89
99202 New patient office or other outpatient visit, typically 20 minutes	84	84	$77.71	$50.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	73	60	$114.10	$75.88
17110 Destruction of up to 14 skin growths	64	33	$113.00	$69.70
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	63	57	$308.00	$175.38
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	45	39	$252.00	$81.84
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	44	30	$177.00	$94.09
17004 Destruction of precancer skin growth, 15 or more growths	34	27	$153.00	$99.65
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	32	27	$146.00	$75.87
11900 Injection into skin growth, 1-7 growths	30	21	$57.00	$27.02
69100 Biopsy of ear	20	17	$103.00	$32.98
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	14	12	$299.00	$193.86
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	12	11	$260.00	$93.06
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	12	11	$291.00	$187.64

Medical Specialties & State Licenses

CMS Verified: 2021-11-02

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License UT 5131797-1204

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Dermatology

NUCC Taxonomy Code: 207N00000X

State License WA OP60440339

Hospital & Practice Group Affiliations

Uintah Basin Medical Center

210 W 300, Roosevelt, UT 840662336

Uintah Basin Medical Center

250 W 300, Roosevelt, UT 840662336

Phone: 4357224691

Northeastern Utah Medical Group

475 N 500, Vernal, UT 840781907

Phone: 4357812030

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

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Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location November 02, 2021

Registered at 210 W 300 N, ROOSEVELT, UT 840662336 (Tel: 4357224691)

📍

Updated Business Mailing Address November 02, 2021

Registered at 210 W 300 N, ROOSEVELT, UT 840662336 (Tel: 4357257448)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 02, 2021

Dermatology (License #5131797-1204 in UT)

✅

NPI Profile Active May 14, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location May 14, 2014

Registered at 2320 FREEWAY DRIVE, SKAGIT REGIONAL CLINICS-RIVERBEND, MOUNT VERNON, WA 98273 (Tel: 3608146800)

📍

Updated Business Mailing Address May 14, 2014

Registered at 1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 982744127 (Tel: 3604282500)

👤

Provider Name / Credentials Updated May 14, 2014

Recorded as SAMUEL WILSON, DO

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 14, 2014

Dermatology (License #OP60440339 in WA)

🟢

Initial NPI Registration & Enumeration July 10, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1477865194

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 10, 2010

Last Update: November 02, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

210 W 300 N

Roosevelt, UT 840662336

Phone: 4357257448

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.