DR. PHILLIP FAIRBOURN (M.D.) – Diagnostic Radiology Physician, NPI 1801182357
Diagnostic Radiology Physician
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Profile Insights
NPPES metrics only — not quality of care.
345 DIAGNOSTIC RADIOLOGY in UT
Provider Addresses for DR. PHILLIP FAIRBOURN (M.D.)
1055 N 500 W Ste 112
Provo, UT 846043305
Phone: (801) 812-4624
Type: Location
1490 E FOREMASTER DR BLDG C
ST GEORGE, UT 847904550
Phone: (801) 812-4624
Type: Location
2825 E Mall Dr
St George, UT 847901954
Phone: (435) 986-2238
Fax: (435) 986-2237
Type: Location
3000 N Triumph Blvd Ste 100
Lehi, UT 840434999
Phone: (801) 812-4624
Type: Location
1175 E 50 S Ste 141
American Fork, UT 840032845
Phone: (801) 492-5996
Type: Location
555 W SR 164
Salem, UT 84653
Phone: (801) 812-4624
Type: Location
1055 N 500 W
ATTN CREDENTIALING
PROVO, UT 846043305
Phone: (801) 354-8225
Fax: (801) 418-0941
Type: Mailing
2825 E MALL DR
ST GEORGE, UT 847901954
Phone: (435) 986-2238
Fax: (435) 986-2237
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $36.
Total Amount is formed as General ($36) + Research ($0) + Ownership ($0) = $36.
Last reported payment date: 2024-06-26 • Largest payer in this snapshot: Amgen Inc. ($23).
Total Amount
$36
General + Research + Ownership
Payments
2
Total payment records
General Amount
$36
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $23 |
| Phathom Pharmaceuticals, Inc. | $13 |
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: 2018-08-07
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180807003995 | I | Diagnostic Radiology | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 7,168 | 105 | $0 |
| A9585 | Injection, gadobutrol, 0.1 ml | 3,661 | 52 | $0 |
| 73721 | Mri scan of leg joint without contrast | 196 | 184 | $0 |
| 77080 | Dxa bone density measurement of hip, pelvis, spine | 175 | 175 | $0 |
| 77063 | Screening 3d breast mammography | 147 | 147 | $0 |
Insurance plans in this area (ZIP 84604)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| - | UT | |
| Physical Therapist In Private Practice | UT | |
| Orthopedic Surgery | UT | |
| Nurse Practitioner | OR | |
| - | FL | |
| - | UT | |
| - | UT | |
| Nurse Practitioner | UT | |
| - | UT |
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