Physician Laboratory Services – Pain Medicine (Anesthesiology) Physician, NPI 1144509985
Pain Medicine (Anesthesiology) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Physician Laboratory Services
652 S MEDICAL CENTER DR
STE 110
SAINT GEORGE, UT 847907017
Phone: (435) 656-2828
Type: Mailing
2891 E Mall Drive, Ste 200
St. George, UT 847908479
Phone: (435) 688-1665
Fax: (435) 619-8634
Type: Location
PO BOX 912042
SAINT GEORGE, UT 847912042
Phone: (435) 656-2424
Fax: (435) 656-2828
Type: Mailing
2891 E MALL DRIVE, STE. 101
SAINT GEORGE, UT 84791
Phone: (435) 656-2424
Fax: (435) 656-2828
Type: Location
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: 2015-10-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-03-31 (806 days ago).
Enrollment records
2
Earliest due date
2024-03-31
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 |
|---|---|---|---|---|
| O20111117000308 | O | Clinic/Group Practice | UT | 2024-03-31 |
| O20151022000861 | O | Physician - General Practice | UT | 2024-10-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 84790)
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