Individual provider Active NPI

Bryce Larre Egbert, MD

  • Anesthesiology Physician
  • Ogden, UT
National Provider Identifier
1053677906
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5620774-1205 Issued in UT
Practice address
4401 Harrison Blvd
Ogden, UT 84403-3195
Phone
(801) 387-2800
Fax
(770) 701-6675
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5620774-1205 UT Primary

Addresses

Primary practice location

4401 Harrison Blvd
Ogden, UT 84403-3195

Mailing address

PO Box 3570
Salt Lake City, UT 84110-3570
Phone (801) 727-2056

Other practice location 1

201 W Layton Pkwy
Layton, UT 84041-3692
Phone (801) 543-6000

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
I20180507001913 UT Practitioner - Anesthesiology 5698066785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain West Anesthesia LLCGroup PAC ID 9032018502, 267 clinicians

Practice addresses (Care Compare)

4401 Harrison Blvd
Ogden, UT 84403-3195
Phone (801) 387-2800

Hospital & facility affiliations

  • Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004
  • Intermountain Health Layton Hospital Hospital, Layton, UT, CCN 460061

Merit-based Incentive Payment System (MIPS)

Final score
87.53 of 100Reported as group
Quality
89.3
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16349NVMDIntermediate Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc Anesthesiology CurrentSince Mar 1, 2020 Accepting new patients
Ihc Health Services, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Mountain West Anesthesia LLC Anesthesiology CurrentSince Jun 1, 2018 Accepting new patients

Locations

201 W Layton Pkwy
Layton, UT 84041
Phone (801) 543-6000

3340 N Center St
Ste 800
Lehi, UT 84043
Phone (800) 501-4788

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056

4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1053677906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3570",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841103570",
            "telephone_number": "801-727-2056",
            "fax_number": "770-701-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033195",
            "telephone_number": "801-387-2800",
            "fax_number": "770-701-6675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 W Layton Pkwy",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840413692",
            "country_code": "US",
            "telephone_number": "801-543-6000",
            "fax_number": "770-701-6675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGBERT",
        "first_name": "BRYCE",
        "middle_name": "LARRE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "5620774-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.