CRAIG AARON PACKHAM (PA-C) – Medical Physician Assistant, NPI 1104920354

CRAIG AARON PACKHAM (PA-C) is a healthcare provider. based in Tooele, Utah. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 51058218002 (UT). The NPI Number for CRAIG AARON PACKHAM (PA-C) is 1104920354

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
CRAIG AARON PACKHAM (PA-C)
NPI
1104920354
Phone
(435) 882-2350
Address
2356 N 400 E Ste 201
Enumeration Date
9 September 2006
Last Update Date
15 July 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4358822350
Graduation Year
2008 (18 years ago)
PAC ID
2860559523
Group Practice PAC ID
6406813070
Professional Enrollment ID
I20090324000542
Address ID
UT840743409TO2356X400X305
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,971 PHYSICIAN ASSISTANT in UT

Provider Addresses for CRAIG AARON PACKHAM (PA-C)

  • 2356 N 400 E Ste 201

    Tooele, UT 840743409

    Phone: (435) 882-2350

    Fax: (435) 880-2039

    Type: Location

  • North 400 East, Tooele, Tooele County, Utah, 84074, United States

    STE 102

    TOOELE, UT 84074

    Phone: (435) 833-9180

    Fax: (435) 833-9177

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 23 Open Payments records for all available years, with a total value of $530.

Total Amount is formed as General ($530) + Research ($0) + Ownership ($0) = $530.

Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Medtronic, Inc. ($172).

Total Amount

$530

General + Research + Ownership

Payments

23

Total payment records

General Amount

$530

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-11

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2009-03-24

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
I20090324000542IPhysician AssistantUTTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg972111$0
20610Aspiration and/or injection of fluid from large joint29095$0
99214Established patient office or other outpatient visit, 30-39 minutes258156$0
99213Established patient office or other outpatient visit, 20-29 minutes13983$0
J7323Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose11725$0
View full utilization report →

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: 6406813070View full group profile
NameSpecialtyState
Physician AssistantUT
Physician AssistantUT
-UT

Reviews

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Frequently asked questions

Can I use this page to confirm CRAIG AARON PACKHAM (PA-C)'s NPI?
Yes. CRAIG AARON PACKHAM (PA-C) is listed with NPI 1104920354 in the public NPI dataset.
Can I rely on CRAIG AARON PACKHAM (PA-C) being an active provider?
As of the registry snapshot, CRAIG AARON PACKHAM (PA-C) is marked active.
What taxonomy line describes CRAIG AARON PACKHAM (PA-C)?
For research purposes, treat CRAIG AARON PACKHAM (PA-C) as Medical Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for CRAIG AARON PACKHAM (PA-C)?
CRAIG AARON PACKHAM (PA-C)'s geographic hint is Tooele, Utah in our summary view.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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