DR. JOHN BRYAN ELLSWORTH (M.D.) – Urology Physician, NPI 1083619043
Urology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
97 UROLOGY in UT
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Provider Addresses for DR. JOHN BRYAN ELLSWORTH (M.D.)
108, South 900 East, St. George, Washington County, Utah, 84770, United States
ST GEORGE, UT 847907002
Phone: (435) 628-3606
Fax: (435) 628-8404
Type: Mailing
340 Falcon Ridge Pkwy Ste 203
Mesquite, NV 890278851
Phone: (435) 628-3606
Fax: (435) 628-8404
Type: Location
4951 S White Mountain Rd Bldg A
Show Low, AZ 859017827
Phone: (928) 537-6700
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 51 Open Payments records for all available years, with a total value of $2,933.
Total Amount is formed as General ($2,933) + Research ($0) + Ownership ($0) = $2,933.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: Boston Scientific Corporation ($2,405).
Total Amount
$2,933
General + Research + Ownership
Payments
51
Total payment records
General Amount
$2,933
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $2,405 |
| ABBVIE INC. | $191 |
| PROCEPT BioRobotics Corporation | $134 |
| Sumitomo Pharma America, Inc. | $113 |
| Axonics, Inc. | $74 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-05-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20120224000426 | I | Urology | UT | TBD |
| I20250423002760 | I | Urology | AZ | TBD |
| I20250502001680 | I | Urology | PA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1071 | Injection, testosterone cypionate, 1 mg | 34,203 | 19 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 647 | 480 | $0 |
| 81002 | Urinalysis, manual test | 551 | 328 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 523 | 410 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 328 | 121 | $0 |
Insurance plans in this area (ZIP 84790)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AZ | |
| - | OH | |
| Nurse Practitioner | AZ | |
| Physician Assistant | AZ | |
| - | AZ | |
| Family Practice, Critical Care (Intensivists) | AZ | |
| O B S T E T R I C S/ G Y N E C O L O G Y | AZ | |
| - | AZ | |
| - | AZ | |
| - | AZ |
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