BRYAN ELLIS (PA-C) – Physician Assistant, NPI 1174288575
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,971 PHYSICIAN ASSISTANT in UT
Provider Addresses for BRYAN ELLIS (PA-C)
62 E Thrive Dr Ste 220
Saratoga Springs, UT 840455560
Phone: (801) 768-8800
Fax: (801) 820-8200
Type: Location
1055 N 300 W Ste 303
Provo, UT 846043373
Phone: (801) 768-8800
Fax: (801) 820-8200
Type: Location
13658 S FORT ST
DRAPER, UT 840209278
Phone:
Type: Mailing
680 E MAIN ST STE 201
LEHI, UT 840432251
Phone: (801) 768-8800
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 161 Open Payments records for all available years, with a total value of $3,328.
Total Amount is formed as General ($3,328) + Research ($0) + Ownership ($0) = $3,328.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($558).
Total Amount
$3,328
General + Research + Ownership
Payments
161
Total payment records
General Amount
$3,328
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $558 |
| Arcutis Biotherapeutics, Inc. | $347 |
| UCB, Inc. | $279 |
| Galderma Laboratories, L.P. | $239 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $225 |
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: 2021-12-28
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211228001795 | I | Physician Assistant | UT | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84045)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| D E R M A T O L O G Y | UT | |
| Nurse Practitioner | UT | |
| D E R M A T O L O G Y | MO | |
| Physician Assistant | UT | |
| Physician Assistant | UT | |
| Physician Assistant | UT | |
| Physician Assistant | UT |
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