Individual provider Active NPI

John Emil Wennergren, M.D.

  • Surgery Physician
  • Lehi, UT
National Provider Identifier
1053545434
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
9362974-1205 Issued in UT
Practice address
3000 N Triumph Blvd Ste 250
Lehi, UT 84043-7187
Phone
(801) 852-9480
Fax
(801) 852-9489
NPI assigned
May 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 9362974-1205 UT Primary

Addresses

Primary practice location

3000 N Triumph Blvd Ste 250
Lehi, UT 84043-7187

Mailing address

3550 N University Ave Ste 250
Provo, UT 84604-6695
Phone (801) 374-9625

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwennergren@utahsurgical.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150806012634 UT Practitioner - General Surgery 7911144647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Colorado School of Medicine, Denver, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians
Utah Surgical Associates IncGroup PAC ID 4486686698, 48 clinicians

Practice addresses (Care Compare)

1034 N 500
Uvh Psych Dept
Provo, UT 84604-3380
Phone (801) 357-7850

3550 N University Ave
Suite 250
Provo, UT 84604-6685
Phone (801) 374-9625

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)12
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47353KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Apr 8, 2020 Accepting new patients
Ihc Health Services Inc Surgery Current Accepting new patients
Utah Surgical Associates, Inc. CurrentSince Jul 24, 2015 Accepting new patients
Ihc Health Services, Inc. CurrentSince Apr 8, 2020 Accepting new patients
Utah Weight Loss, LLC PastSince Jul 24, 2015 Accepting new patients
Granite Peaks Gi, LLC Past Accepting new patients

Locations

170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570

1248 E 90 N
Ste 102
American Fork, UT 84003
Phone (801) 756-9132

3000 N Triumph Blvd
Ste 250
Lehi, UT 84043
Phone (801) 619-9000

15 S 1000 E
Ste 350
Payson, UT 84651
Phone (801) 465-5602

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

1055 N 300 W
Ste 101
Provo, UT 84604
Phone (801) 852-3459

3550 N University Ave
Ste 250
Provo, UT 84604
Phone (801) 374-9625

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

692 E Market Place Dr
Ste 202
Spanish Fork, UT 84660
Phone (801) 852-3230

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: usapro.johnwennergren@143148.advancedmd-direct.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1053545434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 N UNIVERSITY AVE STE 250",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046695",
            "telephone_number": "801-374-9625",
            "fax_number": "801-374-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N TRIUMPH BLVD STE 250",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437187",
            "telephone_number": "801-852-9480",
            "fax_number": "801-852-9489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENNERGREN",
        "first_name": "JOHN",
        "middle_name": "EMIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-13",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "9362974-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwennergren@utahsurgical.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3550 N University Ave Ste 250",
            "city": "Provo",
            "state": "UT",
            "country_code": "US",
            "postal_code": "846046695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

Verify at the official NPI Registry.