ANTHONY WAYNE BACON (M.D.) – Trauma Surgery Physician, NPI 1154611986

ANTHONY WAYNE BACON (M.D.) is a healthcare provider. based in Salt lake city, Utah. specializing in GENERAL SURGERY. They hold the professional credentials M.D.. They hold a License No. 11275378-1205 (UT). The NPI Number for ANTHONY WAYNE BACON (M.D.) is 1154611986

Main info

Male
15 Years Of Experience
Accepts Medicare Assignment
Name
ANTHONY WAYNE BACON (M.D.)
NPI
1154611986
Phone
(801) 585-1618
Address
30 N 1900 E RM 3C344
Enumeration Date
13 April 2011
Last Update Date
13 April 2026

Doctor Profile

Medical School Name
UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Secondary Phone
8015074384
Graduation Year
2011 (15 years ago)
PAC ID
4385957166
Group Practice PAC ID
1850209420
Professional Enrollment ID
I20190605000578
Address ID
UT841075701MU5121XSTXX400

Contacts

Main Contact
https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness95
Years active:15State licenses:1Other names

238 GENERAL SURGERY in UT

Provider Addresses for ANTHONY WAYNE BACON (M.D.)

  • 30 N 1900 E RM 3C344

    SALT LAKE CITY, UT 841320002

    Phone: (801) 585-1618

    Type: Mailing

  • 5121 S Cottonwood St

    Murray, UT 841075701

    Phone: (801) 442-2000

    Type: Location

  • 5169 S COTTONWOOD ST STE 400

    MURRAY, UT 841076769

    Phone: (801) 507-3460

    Type: Location

  • PO BOX 27128

    SALT LAKE CITY, UT 841270128

    Phone: (801) 507-3460

    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: 2019-06-05

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
I20190605000578IGeneral SurgeryUTTBD

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
99231Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes6526$0
99284Emergency department visit with moderate level of medical decision making1111$0
View full utilization report →

Insurance plans in this area (ZIP 84132)

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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: 1850209420View full group profile

Reviews

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Frequently asked questions

Is there an official ID for ANTHONY WAYNE BACON (M.D.) in U.S. healthcare records?
The official identifier for ANTHONY WAYNE BACON (M.D.) is NPI 1154611986.
Is there an active status for ANTHONY WAYNE BACON (M.D.)?
For scheduling context, ANTHONY WAYNE BACON (M.D.) is shown as active in the registry.
What clinical focus is listed for ANTHONY WAYNE BACON (M.D.)?
At a glance, ANTHONY WAYNE BACON (M.D.) is tied to Trauma Surgery Physician. Clinical services aligned with this taxonomy classification.
Where in Utah is ANTHONY WAYNE BACON (M.D.) registered?
Use Salt Lake City, Utah as the headline location for ANTHONY WAYNE BACON (M.D.) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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