Unknown Individual – Medical Physician Assistant, NPI 1114261005
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
4460 S HIGHLAND DR
400
SALT LAKE CITY, UT 841243543
Phone: (801) 272-4111
Fax: (801) 272-5989
Type: Mailing
1775 E 4500 S
HOLLADAY, UT 841174257
Phone: (801) 272-4408
Fax: (801) 272-4441
Type: Mailing
4460 S Highland Dr
400
Salt Lake City, UT 841243543
Phone: (801) 272-4111
Fax: (801) 272-5989
Type: Location
150 N Main St Ste 202
Heber City, UT 840321671
Phone: (435) 658-1013
Type: Location
1790 Sun Peak Dr Ste A103
Park City, UT 840986625
Phone: (435) 658-1013
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $591.
Total Amount is formed as General ($591) + Research ($0) + Ownership ($0) = $591.
Last reported payment date: 2024-09-05 • Largest payer in this snapshot: ABBVIE INC. ($402).
Total Amount
$591
General + Research + Ownership
Payments
21
Total payment records
General Amount
$591
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $402 |
| Dermavant Sciences, Inc. | $124 |
| Arcutis Biotherapeutics, Inc. | $24 |
| Merz North America, Inc. | $16 |
| PFIZER INC. | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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 84124)
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Reviews
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