Individual provider Active NPI

Sean L. Webster PA-C, PA-C

  • Medical Physician Assistant
  • Bountiful, UT
National Provider Identifier
1063759215
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8482017-1206 Issued in UT
Practice address
557 W 2600 S
Bountiful, UT 84010-7717
Phone
(801) 298-9155
NPI assigned
Jan 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8482017-1206 UT Primary

Addresses

Primary practice location

557 W 2600 S
Bountiful, UT 84010-7717

Mailing address

557 W 2600 S
Bountiful, UT 84010-7717
Phone (801) 298-9155

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
I20150115001220 UT Practitioner - Physician Assistant 9739403072 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joshua Oaks MD PLLCGroup PAC ID 0840776688, 31 clinicians

Practice addresses (Care Compare)

520 Medical Dr
Suite 300
Bountiful, UT 84010-8925
Phone (801) 292-1422

Hospital & facility affiliations

  • Lakeview Hospital Hospital, Bountiful, UT, CCN 460042

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Joshua Oaks MD PLLC Family Medicine CurrentSince Jan 1, 2026 Accepting new patients

Locations

520 Medical Dr
Ste 300
Bountiful, UT 84010
Phone (801) 292-1422

557 W 2600 S
Bountiful, UT 84010
Phone (801) 296-5805

Interoperability endpoints

  • Direct secure messaging: sean.webster.1@16218.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1063759215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 W 2600 S",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107717",
            "telephone_number": "801-298-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 W 2600 S",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107717",
            "telephone_number": "801-298-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER PA-C",
        "first_name": "SEAN",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-08",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "8482017-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.