TYSON JAMES BRINKERHOFF (PMHNP-BC) – Registered Nurse, NPI 1104624774

TYSON JAMES BRINKERHOFF (PMHNP-BC) is a healthcare provider. based in Tooele, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-BC. They hold a License No. 10826752-3102 (UT). The NPI Number for TYSON JAMES BRINKERHOFF (PMHNP-BC) is 1104624774

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
TYSON JAMES BRINKERHOFF (PMHNP-BC)
NPI
1104624774
Phone
(801) 477-4781
Address
323 N MAIN ST
Enumeration Date
7 March 2025
Last Update Date
20 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8014777189
Graduation Year
2025 (1 year ago)
PAC ID
5799261087
Group Practice PAC ID
6406228220
Professional Enrollment ID
I20260107001056
Address ID
UT840626758PL1221XWAYX507
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:1State licenses:2Digital endpointsOther names

2,655 NURSE PRACTITIONER in UT

Provider Addresses for TYSON JAMES BRINKERHOFF (PMHNP-BC)

  • 323 N MAIN ST

    TOOELE, UT 840741652

    Phone: (801) 477-4781

    Fax: (888) 745-9274

    Type: Mailing

  • 323 N MAIN ST STE 101

    TOOELE, UT 840741652

    Phone: (435) 233-7900

    Type: Location

  • 1221 S Valley Grove Way Ste 160

    Pleasant Grove, UT 840626758

    Phone: (801) 477-7189

    Fax: (888) 745-9274

    Type: Location

  • 1244 N MAIN ST STE 101

    TOOELE, UT 840749839

    Phone: (435) 244-3143

    Fax: (435) 359-5221

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2026-01-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260107001056INurse PractitionerUTTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84074)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406228220View full group profile
NameSpecialtyState
Nurse PractitionerUT
Nurse PractitionerNV
Physician AssistantUT
Nurse PractitionerUT
Nurse PractitionerUT
P S Y C H I A T R YCA
Physician AssistantUT
Nurse PractitionerUT
Clinical Social WorkerUT
Physician AssistantUT

Reviews

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Frequently asked questions

What number should I use to identify TYSON JAMES BRINKERHOFF (PMHNP-BC) for billing?
Administrative and clinical systems typically use NPI 1104624774 for TYSON JAMES BRINKERHOFF (PMHNP-BC).
Is TYSON JAMES BRINKERHOFF (PMHNP-BC)'s NPI status active today?
Active status means TYSON JAMES BRINKERHOFF (PMHNP-BC)'s NPI record is not deactivated in the public file.
What type of care does TYSON JAMES BRINKERHOFF (PMHNP-BC) provide?
TYSON JAMES BRINKERHOFF (PMHNP-BC)'s profile centers on Registered Nurse. Clinical services aligned with this taxonomy classification.
Is TYSON JAMES BRINKERHOFF (PMHNP-BC) tied to Tooele, Utah?
If you are local to Tooele, Utah, TYSON JAMES BRINKERHOFF (PMHNP-BC) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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