Individual provider Active NPI

Gerald C. Fischer, MPAS, ATC

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1053432815
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4977407-1206 Issued in UT
Practice address
127 S 500 E Ste 140
Salt Lake City, UT 84102-2076
Phone
(801) 587-6307
Fax
(801) 587-6313
NPI assigned
Apr 2, 2007
Last updated
Dec 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4977407-1206 UT Primary

Addresses

Primary practice location

127 S 500 E Ste 140
Salt Lake City, UT 84102-2076

Mailing address

1348 E Silvercrest Dr
Sandy, UT 84093-2321
Phone (801) 568-1789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070718000081 UT Practitioner - Physician Assistant 4981705175 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Jan 28, 2017 Accepting new patients
American Current Care P.a. CurrentSince Jan 28, 2017 Accepting new patients
University Health Care Quick Clinic Physician Assistant Past Accepting new patients

Locations

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

385 W 9000 S
Sandy, UT 84070
Phone (801) 562-5200

1735 S Redwood Rd
Ste 115
Slc, UT 84104
Phone (801) 973-4434

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1053432815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 E SILVERCREST DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840932321",
            "telephone_number": "801-568-1789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S 500 E STE 140",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022076",
            "telephone_number": "801-587-6307",
            "fax_number": "801-587-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "GERALD",
        "middle_name": "C.",
        "credential": "MPAS, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "4977407-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.